血清25-羟维生素D_3和IL-17水平变化在肥胖儿童非酒精性脂肪肝病进展中的作用

Effect of serum level change of 25-( OH) D_3 and IL-17 in obesity children with NAFLD

目的探讨血清25-羟维生素D_3[25-(OH)D_3]和白介素17(IL-17)水平变化在肥胖儿童非酒精性脂肪肝病(NAFLD)进展中的作用。方法选择本院门诊和住院肥胖患儿168例,按照NAFLD诊疗指南分为单纯性肥胖组(SOC,60例)、单纯性非酒精性脂肪肝组(NAFL,62例)和非酒精性脂肪肝炎组(NASH,46例),另选取健康体检儿童为对照组(50例)。分别采用电化学发光法和ELISA法测定血清25-(OH)D_3及IL-17水平,酶法测定血清ALT和AST活性,并行相关分析。结果与对照组比较,肥胖儿童NAFLD患者血清25-(OH)D_3水平显著降低,而血清IL-17水平明显升高(P<0.01);随着病情的进展血清25-(OH)D_3水平逐渐降低,而血清IL-17水平逐渐升高,组间比较差异均有统计学意义(P<0.01),25-(OH)D_3与IL-17、ALT及AST水平呈负相关,而IL-17与ALT、AST水平呈正相关。结论肥胖儿童血清25-(OH)D_3水平降低和IL-17表达升高,可能参与NAFLD的发生与发展,且与脂肪肝严重程度密切相关,其可作为评估肝损伤严重程度的生物学标志物。

Objective To elucidate the role of serum level change of 25-（ OH） D_3 and IL-17 in the progress of obesity children NAFLD. Methods A total of 168 obesity children at our hospital were divided into simple obesity group（ SOC,n = 60）,simple nonalcoholic fatty liver group（ NAFL,n = 62） and nonalcoholic steatohepatitis group（ NASH,n = 46）,according to the NAFLD guidelines. Fifty healthy children were set as control group（ NC）. Serum levels of 25-（ OH） D_3 and IL-17 were detected by the chemiluminescence immumoassay（ CLIA） and the enzyme linked immunosorbent assay（ ELISA）,serum alanine aminotransferase（ ALT） and aspartate aminotransferase（ AST） were detected by antomatic enzyme assay. Also,we analyzed the correlations between these parameters. Results Compared to NC group,the obesity NAFLD patients had higher level of 25-（ OH） D_3 but lower level of IL-17. With the severity of the NAFLD,the serum level of 25-（ OH） D_3 was getting more lower,and the serum level of IL-17 was getting more higher,with the differences among different groups statistically significant（ P 〈0. 01）. The correlation analysis showed that the serum level of 25-（ OH） D_3 was negatively correlated with the serum level of IL-17,ALT or AST,and the serum level of IL-17 was positively correlated with the serum level of ALT or AST. Conclusion The serum level of 25-（ OH） D_3 decreased and the serum level of IL-71 increased in obesity NAFLD patients,and the serum level change was correlated with severity of fatty liver,indicating 25-（ OH） D_3 and IL-17 may play roles in NAFLD pathogenesis,and may be biomarkers for severity of liver injury.