非酒精性脂肪性肝病患者Hyc及血管内皮功能与冠心病发病风险相关性

Correlations of homocysteine with endothelial function and 10-year coronary heart disease incidences in patients with nonalcoholic fatty liver disease

目的:探讨非酒精性脂肪性肝病(NAFLD)患者血浆同型半胱氨酸(Hyc)及血管内皮功能与冠心病(CHD)发病风险之间的关系。方法:选取105例NAFLD患者,采用酶循环法检测血浆Hyc浓度,超声检测患者肱动脉内径变化率(FMD)以及颈动脉内中膜厚度(IMT)评估患者血管内皮功能,采用Framingham风险评分(FRS)评估其未来10年CHD的发病风险,分析Hyc与血管内皮功能以及10年CHD发病风险的关系。结果:高Hyc组的FMD显著低于正常组(P<0.01),IMT和FRS显著高于正常组(P<0.05或P<0.01);10年CHD风险≥0组的IMT和Hyc显著高于10年CHD风险<0组,FMD显著低于10年CHD风险<0组(P<0.05或P<0.01);Logistic回归分析显示Hyc与血管内皮功能呈负相关,与10年CHD风险呈正相关。结论:NAFLD合并高Hyc血症者内皮功能降低,10年CHD风险升高,Hyc与患者血管内皮功能以及10年CHD风险密切相关。

Objective: To investigate the correlations among homocysteine(Hyc),endothelial function and risk for coronary heart disease in patients with nonalcoholic fatty liver disease(NAFLD).Methods: 105 cases of NAFLD were enrolled in this study.Serum Hyc concentration was measured by enzyme circulation method,FMD of brachial artery and IMT of carotid artery were measured by ultrasound to evaluate endothelial function.Framingham risk score was used to assess the risk of CHD in the next 10 years,and the relationships between Hyc and endothelial function and the risk of CHD in the next 10 years were analyzed.Results:The FMD of brachial artery in high Hyc group was significantly lower than that in normal group(P<0.01),the IMT and FRS of carotid artery were significantly higher than those in normal group(P<0.05 or P<0.01);compared with those in 10-year CHD risk < 0 group,the IMT and Hyc of carotid artery in 10-year CHD risk≥0 group increased significantly,the FMD of brachial artery decreased significantly(P<0.05 or P<0.01).Logistic regression analysis showed that plasma Hyc was negatively correlated with vascular endothelial function,and positively correlated with 10-year CHD risk.Conclusion: The endothelial function decreases and10-year CHD risk increases in NAFLD patients with high plasma Hyc.Hyc is closely related to the endothelial function of patients and 10-year CHD risk.