血清25(OH)维生素D与非酒精性脂肪性肝病肝纤维化的相关性研究

Correlation between serum 25(OH) vitamin D and liver fibrosis in nonalcoholic fatty liver disease

目的探讨血清25(OH)维生素D(25(OH)D)与非酒精性脂肪性肝病患者肝纤维化的关系。方法本实验集中选取同一地区秋季人群为研究对象,时间为2017年8~10月非酒精性脂肪性肝病者120例,根据肝纤维化评分(NFS)分为<-1.455亚组(可排除肝纤维化亚组),-1.455~0.676亚组(不确定亚组),>0.676亚组(肝纤维化亚组);选择同期体检的年龄、性别、地域相匹配的健康人群50例为对照组,应用ELISA法检测血清25(OH)D、CK18及YKL40水平。使用SPSS 19.0软件包对数据进行分析,肝纤维化指标和血清25(OH)D含量用(x^-±s)表示,两两比较采用t检验,多组间比较采用方差分析及Spearman相关分析。P<0.05表示差异有统计学意义。结果NFS>0.676组随着血清肝纤维化指标CK18、YKL40的升高,血清25(OH)D含量减低,呈负相关关系(P<0.05)。其他各组与血清25(OH)D含量未发现相关关系(P>0.05)。结论非酒精性脂肪性肝炎有肝纤维化趋势,血清25(OH)D与肝纤维化的进展密切相关。

Objective To investigate the relationship between serum 25(OH)vitamin D and liver fibrosis in patients with nonalcoholic fatty liver disease.Methods The experiment was focused on the autumn population in the same area.From August to October 2017,120 patients with nonalcoholic fatty liver disease were divided into<-1.455 subgroup according to nonalcoholic fatty liver fibrosis score(NFS).Excluding the liver fibrosis subgroup),-1.75-0.676 subgroup(unsure subgroup),>0.676 subgroup(liver fibrosis subgroup),50 healthy people with age,gender,and geographical matching were matched for the same physical examination In the control group,serum 25(OH)vitamin D,CK18 and YKL40 levels were measured by ELISA.SPSS 19.0 statistical software was used for data analysis.Liver fibrosis indexes and serum 25(OH)vitamin D were showed as(±s),compared with independent t test.Multiple date sets were compared with Variance and Spearman correlation analysis,P<0.05 indicated the difference was statistically significant.Results Serum 25(OH)vitamin D content decreased with the increase of serum liver fibrosis markers CK18 and YKL40 in NFS>0.676 group(P<0.05).There was no correlation between CK18,YKL40 and serum 25(OH)vitamin D in normal group,NFS<-1.455 group and-1.455≤NFS≤0.676 group(P>0.05).Conclusions Nonalcoholic steatohepatitis has a trend of liver fibrosis,and serum 25(OH)vitamin D is closely related to the progression of liver fibrosis.