非酒精性脂肪性肝病患者粪便钙卫蛋白检测及其意义

Fecal calprotectin measurement in patients with non-alcoholic fatty liver disease

目的探讨粪便钙卫蛋白(FC)评估非酒精性脂肪性肝病(NAFLD)患者肠道炎症状态的应用价值。方法纳入NAFLD和健康人,采用酶联免疫吸附试验检测粪便钙卫蛋白水平,并收集两组研究对象的一般资料和血生化指标。结果 91例正常人和81例NAFLD患者体质指数(BMI)分别为(22.6±2.4)kg/m2和(28.5±4.0)kg/m2,腰围分别为(80.9±7.9)cm和(91.6±9.5)cm,血清谷草转氨酶(AST)分别为(19.3±4.8)u/L和(33.7±18.7)u/L,谷丙转氨酶(ALT)分别为(17.5±7.1)u/L和(55.0±44.5)u/L,甘油三酯(TG)分别为(0.9±0.3)mmol/L和(2.4±2.3)mmol/L,总胆固醇(TC)分别为(4.3±0.6)mmol/L和(5.1±1.3)mmol/L,差异均有统计学意义(P<0.05);NAFLD组FC水平为43.0(18.8~87.0)μg/g,显著高于正常人的11.4(4.6~24.4)μg/g,差异有统计学意义(P<0.00);NAFLD组和正常人FC水平大于50μg/g者分别为48例(59.3%)和6例(6.6%),两者构成比差异具有统计学意义(x2=55.178,P<0.001);相关性分析显示,NAFLD患者FC水平与BMI、腰围、血清GGT、TC水平呈正相关(r=0.725,r=0.570,r=0.292,r=0.400,P值均<0.05);多因素分析发现,低水平的HDL、高水平的TG、BMI和TC是NAFLD发病的独立危险因素(OR=0.011,OR=13.558,OR=1.821,OR=3.086,P值均<0.01)。结论 NAFLD患者粪便FC水平升高,反映肠道可能存在一定的炎症。

Objective To assess the state of gut inflammation in patients with non-alcoholic fatty liver diseae （NAFLD） by using fecal calprotectin measurement. Methods In NAFLD patients and healthy persons,the fecal calprotectin levels were measured by enzyme-linked immunosorbent assay,and the demographic data and biochemical parameters were collected. Results Eighty-one NAFLD patients and 91 healthy subjects were recruited in this study. The body mass index （BMI） in the healthy controls and in the NAFLD patients were （22.6±2.4） kg/m2 vs. （28.5±4.0） kg/m2,waist circumference were （80.9±7.9） cm vs. （91.6±9.5） cm,AST was （19.3±4.8） IU/L vs. （33.7±18.7） IU/L,ALT was （17.5±7.1） IU/L vs. （55.0±44.5） IU/L,TG was（0.9±0.3） mmol/L vs. （2.4±2.3） mmol/L,TC was （4.3±0.6） mmol/L vs. （5.1±1.3） mmol/L,all of the difference were statistically signifieant（P〈0.05）;the fecal calprotectin levels in the patients with NAFLD was 43.0（18.8±87.0）μg/g,much higher than 11.4（4.6±24.4） μg/g in the control （P〈0.001）;There were positive correlations between fecal calprotectin levels and BMI,waist circumference, TC and GGT （r =0.725, r =0.570, r =0,292, and r =0.400, respectively, all P 〈0.010 ） ; Multivariate analysis demonstrated that a low level of HDL,and a high level of TG,BMI,and TC were independent risk factors for NAFLD （OR=O.Oll,OR=3.558,0R=l.821,OR=3.086,respectively,all P〈0.01）. Conclusion Fecal calprotectin levies increases in NAFLD patients,which might reflect the intlammation state of the gut.