总胆固醇与高密度脂蛋白胆固醇比值与肝脏脂肪变的相关性研究

Correlation between total cholesterol to high-density lipoprotein cholesterol ratio and hepatic steatosis severity

目的:探讨总胆固醇(total cholesterol,TC)与高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)比值(TC/HDL-C)与肥胖患者肝脏脂肪变病理分级之间的关系。方法:选取2018—2019年在南京医科大学第一附属医院进行减重外科手术,且经腹部B超检查诊断为非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的肥胖住院患者98例为研究对象,测量其身高、体重、血压,空腹取血行肝肾功能、血脂、血糖等相关指标检查。按照肝脏脂肪变病理分级结果将其分为轻、中、重3组;用Spearman相关性分析及Logistic回归模型分析TC/HDL-C等相关指标与脂肪变病理分级间的关系。结果:①中、重度脂肪肝患者的TC/HDL-C、低密度脂蛋白胆固醇、体重指数、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶等均高于轻度脂肪肝患者(P<0.05),而中度与重度脂肪肝患者相比以上指标均无显著性差异;②Spearman相关分析发现,TC/HDL-C与轻、中度脂肪肝患者的脂肪变严重程度、TC、甘油三酯等因素呈正相关(P<0.05),与HDL-C呈负相关(P<0.05);③Logistic回归分析显示,轻中度脂肪肝患者TC/HDL-C与脂肪变病理分级有显著相关性(P<0.05)。结论:肥胖伴中度脂肪变患者的TC/HDL-C高于轻度患者(P<0.05),且TC/HDL-C与肝脏脂肪变程度存在显著的相关性。

Objective:To investigate the correlation between total cholesterol to high-density lipoprotein cholesterol ratio(TC/HDLC)and hepatic steatosis severity in obese patients with nonalcoholic fatty liver disease.Methods:From 2018 to 2019,a total of 98 obese patients hospitalized in our hospital were recruited.Based on the severity of hepatic steatosis diagnosed with pathological grade,patients were divided into groups with mild-grade(group A),moderate-grade(group B),and severe-grade(group C)hepatic steatosis.The correlation between general clinical characteristics and pathological grade of hepatic steatosis were analyzed by Spearman correlation analysis and logistic regression.Results:①Compared to group A,TC/HDL-C,body mass index(BMI),alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels of group B and group C were significantly higher.There was no significant difference in the above indicators between group B and group C.②Using Spearman correlation analysis,we found that TC/HDL-C was positively correlated with severity of hepatic steatosis,TC,triglyceride and other related factors,while negatively correlated with HDL-C in group A and group B(P<0.05).③Logistic regression analysis showed that there was a significant correlation between TC/HDL-C and pathological grade of hepatic steatosis in group A and group B(P<0.05).Conclusion:TC/HDL-C was significantly higher in patients with moderate steatosis than with mild steatosis,and was significantly correlated with the degree of hepatic steatosis.