血清糖化血红蛋白和IL-6对非酒精性脂肪性肝病发病风险的预测价值探讨

Predictive value of serum glycosylated hemoglobin and IL-6levels on the risk of nonalcoholic fatty liver disease

目的探讨血清糖化血红蛋白(HbA1c)和白细胞介素-6(IL-6)预测非酒精性脂肪性肝病(NAFLD)发病风险的价值。方法2014年3月~2015年9月在我院行体检的健康人群658名,进行为期3年的随访。采用酶联免疫吸附法测定血清IL-6水平,应用Logistic回归分析NAFLD发生的独立危险因素。结果在658名体检人群中,随访发现86例(13.1%)发生NAFLD;NAFLD患者BMI为(26.4±2.5)kg/m^2,显著大于572例健康人[(21.3±2.6)kg/m^2,P<0.05];NAFLD患者血清ALT、AST和GGT水平分别为(55.1±7.2)U/L、(63.1±9.3)U/L和(73.6±6.2)U/L,显著高于健康人[分别为(23.5±6.3)U/L、(21.7±4.4)U/L和(25.1±6.4)U/L,P<0.05];NAFLD患者血TG、LDL-C、FPG和2hPG分别为(2.5±1.1)mmol/L、(1.1±0.2)mmol/L、(5.8±1.0)mmol/L和(7.6±2.3)mmol/L,与健康人[分别为(1.2±0.3)mmol/L、(1.4±0.3)mmol/L、(5.0±0.8)mmol/L和(6.6±2.1)mmol/L,P<0.05]比,差异显著;NAFLD患者血清HbA1c为(6.0±0.9)%,显著高于健康人[(5.0±0.6)%,P<0.05],NAFLD患者血清IL-6水平为(13.3±4.2)ng/L,显著高于健康人[(3.1±0.8)ng/L,P<0.05];多元Logistic回归分析结果显示HbA1c(OR=1.355,95%CI:1.121~2.315)和IL-6(OR=1.368,95%CI:1.056~2.685)是NAFLD发生的独立危险因素。结论血清HbA1c和IL-6异常升高对NAFLD的诊断具有一定的预测价值,值得进一步研究。

Objective The aim of this study was to explore the predictive value of serum glycosylated hemoglobin(HbA1c)and interleukin-6(IL-6)levels on the risk of nonalcoholic fatty liver disease(NAFLD).Methods A total of 658 individuals were recruited in this study,and all of them underwent a comprehensive physical examination in our hospital between March 2014 and September 2015.Blood HbA1c and serum IL-6 levels were assayed,and Logistic analysis was applied to show the independent risk factors for NAFLD.Results Out the 658 individuals for physical check-up,86 cases(13.1%)were found having NAFLD during the three-year follow-up by sonography;the BMI in patients with NAFLD was(26.4±2.5)kg/m^2,significantly higher than[(21.3±2.6)kg/m^2,P<0.05]in 572 healthy persons;serum ALT,AST and GGT levels in patients with NAFLD were(55.1±7.2)U/L,(63.1±9.3)U/L and(73.6±6.2)U/L,significantly higher than[(23.5±6.3)U/L,(21.7±4.4)U/L and(25.1±6.4)U/L,respectively,P<0.05]in the healthy persons;blood TG,LDL-C,FPG and2hPG levels in patients with NAFLD were(2.5±1.1)mmol/L,(1.1±0.2)mmol/L,(5.8±1.0)mmol/L and(7.6±2.3)mmol/L,significantly different as compared to[(1.2±0.3)mmol/L,(1.4±0.3)mmol/L,(5.0±0.8)mmol/L and(6.6±2.1)mmol/L,respectively,P<0.05]in healthy persons;blood HbA1c in patients with NAFLD was(6.0±0.9)%,significantly higher than[(5.0±0.6)%,P<0.05]and serum IL-6 level was(13.3±4.2)ng/L,significantly higher than[(3.1±0.8)ng/L,P<0.05]in the healthy persons;Logistic analysis showed than elevated blood HbA1c(OR=1.355,95%CI:1.121-2.315)and serum IL-6 levels(OR=1.368,95%CI:1.056-2.685)were the risk factors for the occurrence of NAFLD.Conclusion Abnormal elevation of serum glycosylated hemoglobin and IL-6 levels might hint to a certain degree the happening of nonalcoholic fatty liver disease in the future,which must be concerned in clinical practice.