非酒精性脂肪性肝病患者颈动脉内-中膜厚度与肝功能的相关性

Relationship between carotid intima-media thickness and liver function in patients with nonalcoholic fatty liver disease

目的探讨非酒精性脂肪性肝病(NAFLD)患者肝功能与颈动脉内-中膜厚度(CIMT)的相关性。方法检测70例NAFLD患者和40例健康对照者血清ALT、AST、γ-GT、DBil、TBil;采用彩色多普勒超声测量CIMT,CIMT≥0.8 mm者判定为CIMT增厚。结果 NAFLD组CIMT增厚率为55.7%(39/70),显著高于健康对照组27.5%(11/40)(P<0.01);NAFLD组肝功能参数与CIMT行多元线性回归分析,仅γ-GT入选方程,CIMT=0.615+0.004×-γGT;Logistic多元回归分析显示,γ-GT是CIMT增厚的独立危险因素(P<0.01)。结论 NAFLD患者常伴有CIMT增厚,CIMT与-γGT呈正相关;升高的γ-GT可能是NAFLD患者CIMT增厚的危险因素。

Objective To investigate the relationship between carotid intima-media thickness（CIMT） and liver function in patients with nonalcoholic fatty liver disease（NAFLD）.Methods The concentrations of serum alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,gamma-glutamyltransferase（γ-GT）,direct bilirubin（DBIL）,total bilirubin（TBiL） were measured in 70 NAFLD patients and 40 healthy controls.All subjects underwent ultrasound examination for detecting CIMT.CIMT greater than 0.8 mm was defined as abnormally thickening.Results CIMT abnormal thickening rate of NAFLD group was 55.7%（39/70）,which was significantly higher than 27.5%（11/40） of healthy control group（P0.01）.Multiple linear regressions showed that CIMT was associated with γ-GT（CIMT=0.615＋0.004×γ-GT）.Logistic analysis showed that γ-GT level was an independent risk factor for abnormal CIMT thickening in patients with NAFLD（P0.01）.Conclusion Abnormal CIMT thickening is commonly seen in patients with NAFLD.γ-GT is positively correlated with CIMT in patients with NAFLD.Elevated γ-GT may be a risk factor for abnormal CIMT thickening.