FibroScan 502受控衰减参数在非酒精性脂肪肝危险因素监测中的应用

Application of FibroScan 502 controlled attenuation parameters in monitoring of risk factors in nonalcoholic fatty liver diseases

目的通过2年对体检人群使用瞬时弹性记录仪(FibroScan)502检测受控衰减参数(CAP)及非酒精性脂肪肝(NAFLD)危险因素指标的监测,明确CAP对NAFLD监测疾病转归的临床价值。方法选取体检人群528例,应用FibroScan 502检测CAP确定肝脏脂肪度,调查受检者病史、饮酒史、体重、身高,检测血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、空腹血糖(FBS)、尿酸(UA)、总胆固醇(CHO)、三酰甘油(TG)、甲状腺激素水平(FT3、FT4、TSH)、生长激素水平(GH),以体重变化进行分组,组间计量资料采用Kruskal-Wallis H秩和检验。结果根据受检者第2年体重的变化分为7组,体重下降≥12.5%为-3组,7.5%≤体重下降<12.5%为-2组,2.5%≤体重下降<7.5%为-1组,体重增高或下降<2.5%为0组,2.5%≤体重增加<7.5%为+1组,7.5%≤体重增加<12.5%为+2组,体重增加≥12.5%为+3组。CAP、FBS、UA、ALT均随体重变化而变化(P<0.05),而AST、CHO、TG、甲状腺激素水平、生长激素水平未随体重变化而有显著变化(P均>0.05)。结论肥胖与NAFLD密切相关,CAP、FBS、UA、ALT随体重改变而出现显著变化,通过FibroScan 502检测到的CAP结合生化学指标可以动态监测NAFLD的疾病发生、发展与转归。

Objective To investigate the clinical value of controlled attenuation parameter （CAP） in monitoring the outcome of nonalcoholic fatty liver diseases （ NAFLD ） by monitoring the CAP and risk factors of NAFLD for 2 years in physical examination population by means of FibroScan 502. Methods A total of 528 subjects who underwent health examination in our hospital were enrolled in the study. The degree of fatty liver of these subjects was detected according to CAP by using FibroScan 502, and the medical history＇, drinking history, body weight, height, the serum levels of alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, fasting blood glucose （FBS）, uric acid （UA） ,total cholesterol （CHO）, triglyceride （TG）, thyroid hormone （FT3, FT4, TSH）, growth hormone were dtected and compared between two groups. The subjects were grouped according to the changes of body weight, and the Kruskal Wallis H rank sum test was used to analyze statistically the data among the groups. Results According to the changes of body weight on the second year, these subjects were divided into 7 groups, weight loss ≥ 12.5% as group 3, 7.5% ≤ weight loss 〈 12.5% as group 2,2.5% ≤ weight loss 〈7.5% as group 1, weight increase or decrease less than 2.5% as group 0, 2.5% ≤weight increase 〈7.5% as group 1 ＋ , 7.5% ≤weight increase 〈 12.5% as group 2 ＋ , weight increase t〉 12.5% as group 3 ＋. The levels of CAP, FBS,UA, ALT were changed with body weight （P 〈0.05） ,however,the levels of AST,CHO,TG, thyroid hormone, growth hormone did not change with body weight significantly （P 〉 0.05 ）. Conclusion The obesity is closely related with NAFLD. The levels of CAP, FBS, UA, ALT are changed with body weight, which suggests that the CAP detected by FibroScan 502 combined with biochemical indicators can dynamically monitor the pathogenesis, development and prognosis of NAFLD.