首页|尿液铊与非酒精性脂肪性肝病的相关性分析

尿液铊与非酒精性脂肪性肝病的相关性分析

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目的 探讨尿液铊(TL)与非酒精性脂肪性肝病(NAFLD)的关系.方法 选取2017-2020年美国健康与营养检查调查数据(NHANES)中年龄≥18岁的注册参与者,并排除缺乏肝脏瞬时弹性成像数据、尿液TL指标及患有乙型肝炎、丙型肝炎、饮酒量显著的人群.将纳入人群分为NAFLD组和Non-NAFLD组,采用高效液相色谱-电喷雾电离-串联质谱和在线固相萃取联合同位素稀释等方法定量检测尿液TL水平,比较两组人群年龄、性别、种族、婚姻状况、教育、家庭收入与贫困比比值(FMPIR)、体质量指数(BMI)、吸烟、喝酒、糖尿病(DM)、高血压(HTN)、高脂血症(HL)、尿液TL水平.计量资料两组间比较采用成组t检验或Wilicoxon秩和检验;计数资料两组间比较采用χ2检验.通过描述性分析、多因素Logistic回归、限制性三次样条回归分析、亚组分析、交互作用,探究尿液TL与NAFLD的风险关联.结果 共纳入2 511例,NAFLD组1 612例(64.20%),Non-NAFLD组899例(35.80%),NAFLD组尿液TL水平明显高于Non-NAFLD组,差异具有统计学意义[0.18(0.11~0.26)μg/L vs 0.16(0.09~0.25)μg/L,Z=-2.76,P=0.01].调整年龄、性别、种族、教育、婚姻状况、FMPIR、BMI、吸烟、喝酒、DM、HTN、HL协变量后,尿液TL Q4组[比值比(OR)=1.90,95%CI:1.48~2.44]患NAFLD风险显著增加(P<0.01).尿液TL与患NAFLD的风险存在正向剂量-反应关系(P<0.01)且为非线性关系(P<0.01).尿液TL与吸烟、BMI之间存在显著的交互作用(P<0.05),一生吸烟≥100支的人群尿液TL每上升一个四分位数患NAFLD的风险增加50%(OR=1.50,95%CI:1.24~1.80),一生吸烟<100支的人群尿液TL每上升一个四分位数患NAFLD的风险增加20%(OR=1.20,95%CI:1.03~1.40),BMI≥30 kg/m2的人群尿液TL每上升一个四分位数患NAFLD的风险增加30%(OR=1.30,95%CI:1.05~1.70),差异具有统计学意义(P<0.05).结论 尿液TL水平与患NAFLD的风险显著相关.
Association between urinary thallium and nonalcoholic fatty liver disease
Objective To investigate the association between urinary thallium(TL)and nonalcoholic fatty liver disease(NAFLD).Methods Related data were collected from the registered participants aged≥18 years in National Health and Nutrition Examination Survey from 2017 to 2020,with th exclusion of the individuals with a lack of liver transient elastography data and urinary TL indicators and those with hepatitis B,hepatitis C or significant alcohol consumption.A total of individuals were divided into NAFLD group and non-NAFLD group.Urinary TL level was quantitatively measured using high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry and online solid-phase extraction combined with isotope dilution.The two groups were compared in terms of age,sex,race,marital status,education,family income poverty impact ratio(FMPIR),body mass index(BMI),smoking,alcohol consumption,diabetes mellitus(DM),hypertension(HTN),hyperlipidemia(HL),and urinary TL level.The independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.Descriptive analysis,multivariable Logistic regression,restricted cubic spline regression analysis,subgroup analysis,and interaction analysis were conducted to investigate the risk association between urinary TL and NAFLD.Results A total of 2 511 individuals were included,with 1 612(64.20%)in the NAFLD group and 899(35.80%)in the non-NAFLD group,and the NAFLD group had a significantly higher urinary TL level than the non-NAFLD group[0.18(0.11—0.26)μg/L vs 0.16(0.09—0.25)μg/L,Z=-2.76,P= 0.01].After adjustment for the covariates of age,sex,race,education,marital status,FMPIR,BMI,smoking,alcohol consumption,DM,HTN,and HL,the urinary TL Q4 group had a significant increase in the risk of NAFLD(odds ratio[OR]= 1.90,95%confidence interval[CI]:1.48—2.44,P<0.01).There was a positive dose-response relationship(P<0.01)and a non-linear relationship(P<0.01)between urinary TL and the risk of NAFLD.A significant interaction was observed between urinary TL and smoking/BMI(P<0.05).For individuals taking≥100 cigarettes in their lifetime,the risk of NAFLD was increased by 50%for every quartile increase in urinary TL(OR=1.50,95%CI:1.24—1.80),and for individuals taking<100 cigarettes in their lifetime,the risk of NAFLD was increased by 20%for every quartile increase in urinary TL(OR=1.20,95%CI:1.03—1.40);for individuals with a BMI of≥30 kg/m2,the risk of NAFLD was increased by 30%for every quartile increase in urinary TL(OR=1.30,95%CI:1.05—1.70),with a statistical significance(P<0.05).Conclusion Urinary TL level is significantly associated with the risk of NAFLD.

Non-alcoholic Fatty Liver DiseaseThalliumCorrelation of Data

刘亚杰、王睿林、梁子晗、李佳辉、郝玉洁

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河南中医药大学第一附属医院脾胃肝胆病科,郑州 450099

解放军总医院第五医学中心中医肝病科,北京 100039

非酒精性脂肪性肝病 数据相关性

国家自然科学基金中国医药教育协会科研项目

816738062020KTY001

2024

临床肝胆病杂志
吉林大学

临床肝胆病杂志

CSTPCD北大核心
影响因子:1.428
ISSN:1001-5256
年,卷(期):2024.40(4)
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