非酒精性脂肪肝患者血浆同型半胱氨酸水平测定及临床意义

Research on the plasma levels and the clinical significance of homocysteine in nonalcoholic fatty liver disease

目的探讨非酒精性脂肪性肝病(NAFLD)患者空腹血清同型半胱氨酸(Hcy)浓度变化的临床意义,同时探讨在NAFLD中Hcy浓度与叶酸及维生素B12浓度变化的相关性。方法对352例健康体检人群行B超检查,其中NAFLD组159例,正常对照组193例,分别检测血浆Hcy、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、叶酸与维生素B12浓度并进行相关性分析。结果 NAFLD患者血Hcy水平以及ALT、AST、TG、TC、HDL、LDL显著高于正常对照组(P<0.01),多因素Logistic回归分析显示ALT、TG、Hcy、LDL是NAFLD的主要危险因素,并且Hcy与叶酸、维生素B12呈直线负相关。结论 NAFLD患者血Hcy增高,高Hcy血症可能是NAFLD一个新的危险因素,在NAFLD发病中可能起重要作用。并且叶酸、维生素B12水平与Hcy水平具有相关性。

Objective To investigate the clinical significance of serum homocysteine（Hcy） in nonalcoholic fatty liver disease （NAFLD）, to explore their correlations of Hcy, foliate and vitamin B12 in NAFLD. Methods B-ultrasound examination was performed on 352 individuals, of which 159 patients were confirmed with NAFLD and 193 patients served as controls. The plasma levels of Hcy, alanine aminotransferase （ALT）, aspartate transaminase （AST）, cholesterol total （TC）, triglyceride （TG）, high density lipoprotein（HDL）, low density lipoprotein（LDL）,folate and vitamin B12 were tested and their correlations were analyzed. Results The levels of Hcy and ALT, AST, TG, TC, HDL, LDL in NAFLD group were higher than that in normal group （P〈0. 01）, and ALT, TG, Hcy, LDL were risk factors in NAFLD, an inverse linear correlation existed between the plasma levels of Hey and folate ,either between the plasma levels of Hcy and vitamin B12. Conclusion The plasma level of Hcy is enhanced in NAFLD patients, and Hyperhomocysteinemia（HHcy） may be a new risk factor in NAFLD. The levels of folate and vitamin B12 are correlated with Hcy.