非酒精性脂肪肝患者LAP指数、VAI指数、血脂与肾功能关系的临床分析

Clinical analysis on the relationship between LAP index,VAI index,serum lipids and renal function in patients with nonalcoholic fatty liver disease

目的研究非酒精性脂肪肝(NAFLD)患者血脂、脂质蓄积指数(LAP)、内脏脂肪指数(VAI)与肾功能的关系。方法收集NAFLD体检患者1 066例,检测尿酸(UA)、肌酐(Cr)、尿素氮(BUN)、β2微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)、胆固醇(TC)、甘油三酯(TG)、尿微量白蛋白,计算BMI、e GFR、LAP、VAI。结果单纯高甘油三酯组UA高于血脂正常对照组、单纯高胆固醇组(P<0.05);单纯高胆固醇组BUN高于血脂正常对照组、单纯高甘油三酯组(P<0.05)。VAI指数与UA、β2-MG、尿微量白蛋白、RBP呈正相关性(P<0.05),与e GFR负相关性(P<0.05)。LAP指数与UP、β2-MG、尿微量白蛋白、RBP呈正相关性(P<0.05),与e GFR无相关性(P>0.05)。RBP与UA、β2-MG、尿微量白蛋白均呈正相关性(P<0.05),与e GFR呈负相关性(P<0.05)。结论 NAFLD患者可联合血脂、RBP、LAP指数及VAI指数早期发现和评估肾功能损害的程度。

Objective To study the relationship among serum lipids,LAP index, VAI index and renal function in patients with nonalcoholic fatty liver disease. Methods 1066 patients with non alcohol fatty liver disease in our hospital from January 2016 to Decem- ber 2016 were examined. The fasting uric acid （UA） , Creatinine （Cr） , Urea nitrogen （BUN） , beta 2 microglobulin （beta 2 - MG） , Retinal binding protein （RBP） , Cholesterol （ TC ） , Glycerol ester （ three TG ） , Urinary albumin were collected. The measurement of height,weight and waist circumference （WC）, body mass index （BMI） and eGFR, LAP index, VAI index were collected either. Results The UA of high glycerin triacetate was higher than the normal lipid group and high cholesterol group （ P 〈 0.05 ）. The BUN of high cholesterol group was higher than the normal lipid group and high lipid group, high glycerin triacetate group （ P 〈 0.05 ）. Retinal binding protein lipid in normal control group was lower than those of high glycerin triacetate group, high cholesterol group and mixed group （ P 〈 0.05 ）. The eGFR of high glycerin triacetate group was lower than that of normal blood lipid group, high cholesterol group and mixed group （ P 〈 0.05 ）. VAI index was positive correlation with UA and β2 - MG and urinary albumin and RBP （ P 〈 0. 05 ）, nega- tive correlation with eGFR （P 〈 0.05 ） ; the LAP was positive correlation with UA and β2 - MG and urinary albumin and RBP （ P 〈 0.05 ）, but no correlation with eGFR （ P 〉 0.05 ） ; RBP was positive correlation with UA and β2 - MG and urinary albumin （ P 〈 0.05 ）, and negative correlation with eGFR（P 〈 0.05）. Conclusion NAFLD patients can be combined with blood lipids, retinal binding pro- tein, LAP index and VAI index to detect and evaluate renal function damage early.