非酒精性脂肪肝病与亚临床动脉粥样硬化的相关性分析

目的探讨非酒精性脂肪肝病(NAFLD)与亚临床动脉粥样硬化的相关性。方法选取2017年1月至2018年12月NAFLD患者150例,并根据超声影像学诊断标准分为NAFLD轻度组、中度组和重度组,另外选择同期50例体检者作为健康对照组,比较各组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL)等血清学指标及颈动脉内膜中层厚度(cIMT)、颈总动脉僵硬度指数(β)、血管压力-应变弹性系数(Ep)、顺应性(AC)、膨大指数(AI)、单点脉搏波传导速度(PWVβ)等颈动脉超声硬化及弹性参数的差异;根据cIMT检查结果分为cIMT I组、cIMT II组和cIMT III组,分析NAFLD严重程度与cIMT增厚程度的相关性。结果四组各血清学指标、颈动脉超声硬化及弹性参数cIMT、β、Ep、AI和PWVβ检测值,差异均有统计学意义(P<0.05),多重比较分析结果显示,除AI在NAFLD重度组与NAFLD中度组差异无统计学意义(P>0.05),其余指标两两比较差异均有统计学意义(P<0.05);Mantel-Haenszel卡方检验结果显示,NAFLD严重程度与cIMT增厚程度存在线性正相关,Spearman相关系数为0.590,差异有统计学意义(P<0.01)。结论NAFLD患者脂肪变程度越高越容易发生亚临床动脉粥样硬化,应尽早防治NAFLD,延缓NAFLD患者体内的亚临床动脉粥样硬化进程,避免心血管事件的发生。

Objective To investigate the relationship between nonalcoholic fatty liver disease(NAFLD)and subclinical atherosclerosis.Methods A total of 150 patients with NAFLD diagnosed in our hospital from January to February 2018 were enrolled as the study group.According to the diagnostic criteria of ultrasound imaging,they were divided into NAFLD mild,moderate and severe groups.As a healthy control group,serum groups such as triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL)and high-density lipoprotein(HDL)and carotid intima-media thickness(cIMT)were compared.Carotid artery stiffness index(β),vascular pressure-strain elastic coefficient(Ep),compliance(AC),expansion index(AI),single-point pulse wave velocity(PWVβ),etc.Differences in parameters;all subjects were divided into cIMT group I,cIMT group II and cIMT III group according to cIMT examination results,and the relationship between the severity of NAFLD and the degree of cIMT thickening was analyzed.Results The results of analysis of variance showed that the detection values of serum markers,carotid ultrasound sclerosis and elastic parameters cIMT,β,Ep,AI and PWVβwere not completely the same,and the differences were statistically significant(P<0.05).The results of multiple comparison analysis showed that there was no significant difference between the NAFLD severe group and the NAFLD moderate group(P>0.05),and the other two indicators showed statistically significant differences.(P<0.05).Mantel-Haenszel chi-square test showed a linear positive correlation between the severity of NAFLD and the degree of cIMT thickening.The Spearman correlation coefficient was 0.590,and the linear and correlation were statistically significant(P<0.01).Conclusion The higher the degree of steatosis in patients with NAFLD,the more likely it is to have subclinical atherosclerosis.The prevention and treatment of NAFLD should be prevented as soon as possible,and the subclinical atherosclerosis process in patients with NAFLD should be delayed to avoid cardiovascular events.