非酒精性脂肪肝病患者肠道AKK菌与肝功能指标的变化及其影响

The changes of intestinal AKK bacteria and liver function in patients with nonalcoholic fatty liver disease

目的探究非酒精性脂肪肝病(NAFLD)患者肠道AKK菌及肝功能指标的变化及其影响。方法选取我院2017年3月至2018年11月门诊诊断为NAFLD的109名患者作为NAFLD组。选取同期352名健康志愿者作为对照组。比较两组研究对象体质量指数(BMI)、总胆固醇(TG)、甘油三酯(TC)、高密度脂蛋白(H-DLC)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)的水平及粪便中AKK菌的相对数量。结果NAFLD组患者肠道AKK菌均数为(6.12±1.04),对照组为(6.78±1.07),差异有统计学意义(t=5.664,P<0.001)。NAFLD组患者BMI、L-DLC、ALT、AST、GGT的水平显著高于对照组,而H-DLC水平显著低于对照组,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示AKK菌数量和H-DLC为NAFLD的独立保护因素,BMI、ALT、AST、GGT为独立危险因素。结论NAFLD患者肠道中AKK菌数量发生显著变化,AKK菌对NAFLD患者具有保护作用,可为肠道微生物参与NAFLD的发病机制研究提供新的视角。

Objective To explore the changes of intestinal AKK bacteria and liver function in patients with nonalcoholic fatty liver disease(NAFLD).Methods A total of 109 patients who were diagnosed with NAFLD in our hospital from March 2017 to November 2018 were selected as the NAFLD group and 352 healthy volunteers were selected as control group.The levels of BMI,TG,TC,LDL-C,ALT,AST,GGT and AKK bacteria in feces were compared between the two groups.Results The mean AKK bacteria number in the NAFLD group was(6.12±1.04),while that in the control group was(6.78±1.07).The difference was significantly(t=5.664,P<0.001).The levels of BMI,H-DLC,ALT,AST and GGT in the NAFLD group were higher than those in the control group,while the HDL-C level was lower,with statistically significant differences(all P<0.05).Multivariate logistic regression analysis showed that AKK bacteria and H-DLC were the independent protective factors for NAFLD,and BMI,ALT,AST and GGT were independent risk factors.Conclusion There was a significant change in the number of intestinal AKK bacteria in patients with NAFLD,and AKK bacteria have protective effects on patients with NAFLD,which provides a new perspective for the involvement of gut microbes in the pathogenesis of NAFLD.