摘要
目的 探讨慢性丙型肝炎(CHC)合并非酒精性脂肪性肝病(NAFLD)患者血清25-羟维生素D[25(OH)D]水平及其与HCV-RNA载量、糖脂代谢的关系.方法 选取2018年9月至2021年9月医院收治CHC患者174例,根据是否合并NAFLD分为单纯CHC组(110例)和CHC-NAFLD组(64例),选取同期体检健康成人87例(健康组),使用酶联免疫吸附法检测纳入对象血清25(OH)D水平,生化分析检测糖脂代谢指标,荧光定量PCR法检测CHC患者HCV-RNA载量,spearman相关性分析血清25(OH)D水平与HCV-RNA载量、糖脂代谢指标水平的相关性,logistics回归分析CHC合并NAFLD的危险因素.结果 CHC-NAFLD组、CHC组患者中BMI≥28kg/m2比率、HbA1c、FBG、INS、IR、TG和LDL-C水平显著高于健康组(P＜0.05),血清 25(OH)D 水平显著低于健康组(P＜0.05).CHC-NAFLD 组 BMI≥28kg/m2 比率、HbA1c、FBG、INS、IR、TG、LDL-C水平和HCV-RNA载量显著高于CHC组(P＜0.05),血清25(OH)D水平显著低于CHC组(P＜0.05).25(OH)D水平与HbA1c、FBG、IR、TG 水平呈负相关(r=-0.426、-0.387、-0.406、-0.514,P＜0.001).25(OH)D＜42 nmol/L、BMI ≥28 kg/m2、TG≥1.72 mmol/L、HCV-RNA载量≥3.5 × 106 IU/mL是CHC患者合并NAFLD的危险因素(P＜0.05).结论 CHC合并NAFLD患者血清25(OH)D水平降低,25(OH)D水平与HbA1c、FBG、IR、TG呈负相关且其水平升高会增加CHC患者发NAFLD发生风险.
Abstract
Objective To explore the level of serum 25-hydroxyvitamin D[25(OH)D]and its relationship with HCV-RNA load and glucose-lipid metabolism in patients with chronic hepatitis C(CHC)and non-alcoholic fatty liver disease(NAFLD).Methods A total of 174 patients with CHC admitted to the hospital were enrolled between September 2018 and September 2021.According to presence or absence of NAFLD,they were divided into simple CHC group(110 cases)and CHC-NAFLD group(64 cases).A total of 87 healthy adults undergoing physical examination during the same period were enrolled as healthy group.The level of serum 25(OH)D was detected by enzyme-linked immunosorbent assay.The glucose-lipid metabolism indexes were detected by biochemical analysis.HCV-RNA load in CHC patients was detected by fluorescence quantitative PCR.The correlation between serum 25(OH)D and HCV-RNA load,glucose-lipid metabolism indexes was analyzed by Spearman correlation analysis.The risk factors of NAFLD were analyzed by Logistic regression analysis.Results The proportion of BMI ≥28 kg/m2,HbA1c,FBG,INS,IR,TG and LDL-C levels in CHC-NAFLD group and CHC group were significantly higher than those in healthy group(P＜0.05),while level of serum 25(OH)D was significantly lower than that in healthy group(P＜0.05).The proportion of BMI ≥28 kg/m2,HbA1c,FBG,INS,IR,TG and LDL-C levels,and HCV-RNA load in CHC-NAFLD group were significantly higher than those in CHC group(P＜0.05),while level of serum 25(OH)D was significantly lower than that in CHC group(P＜0.05).The level of serum 25(OH)D was negatively correlated with levels of HbA1c,FBG,IR and TG(r=-0.426,-0.387,-0.406,-0.514,P＜0.001).25(OH)D＜42 nmol/L,BMI 28 kg/m2,TG ≥1.72 mmol/L and HCV-RNA load ≥3.5 × 106 IU/mL were risk factors of NAFLD in CHC patients(P＜0.05).Conclusion The level of serum 25(OH)D decreases in patients with CHC and NAFLD.The level of 25(OH)D is negatively correlated with HbA1c,FBG,IR and TG,and whose increase will increase the risk of NAFLD in CHC patients.
基金项目
湖北省卫生健康委指导性项目(WJ2019F009D)
湖北省武汉市医学科研项目(WX20A08)
维普
万方数据