7种矿物质营养素血清水平与代谢综合征患者的非酒精性脂肪性肝病风险关联性

摘要/Abstract

摘要： 目的探究7种血清矿物质(钙、铁、磷、钾、钠、硒、锰)与代谢综合征(MS)患者非酒精性脂肪性肝病(NAFLD)风险的相关性。方法通过对NHANES 数据库2017年至2018年的实验室数据进行分析,建立模型并纳入了年龄、性别、种族/民族、婚姻状况、身体质量指数、吸烟状况、饮酒状况、受教育程度、体育活动强度、糖尿病史和心血管病史等变量。应用Spearman相关矩阵评估生物标志物之间的交叉相关性,应用贝叶斯核机器回归拟合血清矿物质与NAFLD患病风险之间的关联。结果在1661名MS患者中,发现NAFLD患者具有更高的血清硒、锰浓度和较低的血清磷浓度。BKMR模型结果显示,矿物质混合血清浓度和NAFLD患病风险呈正向的线性关系。混合物中单一矿物质浓度硒增加,与NAFLD患病风险呈显著正相关,当其他矿物质浓度固定时,血清硒浓度的IQR增加(从2.25 μmol/L增加到2.64 μmol/L),与NAFLD患病风险增加比例的相关性分别为19.3% (95% CI: 10%~27.5%)、19.1% (95% CI: 11.2%~25.8%)和17.8% (95% CI: 8.9%~26.3%)。提示硒与钾、磷之间可能存在交互作用。结论矿物质混合血清浓度和NAFLD患病风险呈正向的线性关系,其中血清硒浓度的增加与NAFLD患病风险呈显著正相关。

关键词: 代谢综合征, 非酒精性脂肪性肝病, 血清, 矿物质, BKMR模型

Abstract: Objective To investigate the correlation between seven serum minerals (calcium, iron, phosphorus, potassium, sodium, selenium, manganese) and the risk of non-alcoholic fatty liver disease (NAFLD) in patients with metabolic syndrome (MS). Methods By analyzing the laboratory data of the NHANES database from 2017 to 2018, the variables such as age, gender, race/nationality, marital status, body mass index, smoking status, drinking status, education level, intensity of physical activity, diabetes history and cardiovascular history were included in the model. The Spearman correlation analysis was used to evaluate the cross correlation between biomarkers, and Bayesian kernel machine regression (BKMR) model was used to fit the association between serum minerals and the risk of NAFLD. Results Among the 1661 MS patients included, NAFLD patients were found to have the higher serum selenium and manganese concentrations and the lower serum phosphorus concentrations. The results of the BKMR model showed a positive linear relationship between mineral mixed serum concentration and the risk of NAFLD prevalence. The increase in selenium concentration of a single mineral in the mixture is significantly positively correlated with the risk of NAFLD. When the concentration of other mineral concentrations is fixed, the IQR of serum selenium concentration increases from 2.25 μmol/L to 2.64 μmol/L, and the correlation with the proportion of increased risk of NAFLD is 19.3% (95% CI: 10%~27.5%), 19.1% (95% CI: 11.2%~25.8%), and 17.8% (95% CI: 8.9%~26.3%), respectively. In addition, the research suggests that there may be interactions among selenium, potassium, and phosphorus. Conclusion There is a positive linear relationship between the mixed serum concentration of minerals and the risk of NAFLD, with an increase in serum selenium concentration being significantly positively correlated with the risk of NAFLD.

Key words: Metabolic syndrome, Non-alcoholic fatty liver, Serum, Mineral, BKMR model

陈小燕, 孙沛祺, 袁乙富, 曹勤, 蒋元烨. 7种矿物质营养素血清水平与代谢综合征患者的非酒精性脂肪性肝病风险关联性[J]. 肝脏, 2025, 30(5): 659-665.

CHEN Xiao-yan, SUN Pei-qi, YUAN Yi-fu, CAO Qin, JIANG Yuan-ye. A study on the correlation between serum levels of 7 mineral nutrients and the risk of non-alcoholic fatty liver disease in patients with metabolic syndrome[J]. Chinese Hepatolgy, 2025, 30(5): 659-665.

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