非酒精性脂肪性肝病肝纤维化进展与代谢因素的相关性研究

Study on the relationship between liver fibrosis progression and metabolic factors in nonalcoholic fatty liver disease

目的:基于FibroTouch确定非酒精性脂肪性肝病(NAFLD)患者肝脏硬度值(LSM),围绕BMI、血脂、空腹血糖、肾功能等代谢相关指标,分析NAFLD肝纤维化进展与代谢因素的相关性,为NAFLD肝纤维化进展继发代谢系统疾病提供早期预警。方法:选择2019年4月-2020年12月经B超确诊的327例NAFLD患者,计算BMI、空腹血脂、空腹血糖、肾功能等代谢因素相关血清学指标,同时均行FibroTouch测量LSM值,根据LSM值对代谢因素指标进行比较及作相关性分析。结果:(1)据LSM值分为无肝纤维化组、轻微肝纤维化组、显著肝纤维化组,3组CHOL、TG、HDL、GLU、BMI与LSM值比较差异有统计学意义(P<0.05),其中BMI、CHOL、GLU与LSM值呈正相关(r>0),HDL、TG与LSM值呈负相关(r<0);(2)根据LSM值分为无肝纤维化组与肝纤维化组,2组BMI、GLU与LSM值差异有统计学意义(P<0.05),其系数分别为1.136、1.531;(3)根据LSM值分为进展期肝纤维化组与显著肝纤维化组,2组TG、BMI、GLU与LSM值差异有统计学意义(P<0.05),其系数为1.257、1.189、2.230;BMI、GLU与LSM值有明显相关性。结论:BMI、GLU与NAFLD的LSM值关系密切,NAFLD肝纤维化进展对BMI、GLU有一定影响;控制NAFLD患者肝纤维化进展,对于改善机体肥胖、糖类代谢异常有积极意义。

Objective:To determine liver stiffness value(LSM)of patients with nonalcoholic fatty liver disease(NAFLD)based on fibrotouch,and analyze the correlation between liver fibrosis progression and metabolic factors of NAFLD around metabolic related indicators such as body mass index(BMI),blood lipid,fasting blood glucose and renal function,so as to provide early warning for metabolic system diseases secondary to liver fibrosis progression of NAFLD.Methods:From April 2019 to December 2020,327 patients with NAFLD diagnosed by B-ultrasound were selected.BMI was calculated.Fasting blood samples were taken to detect serum lipid,fasting blood glucose,renal function and other metabolic factors.The LSM value was measured by fibrotouch.The metabolic factors were compared and analyzed according to the LSM value.Results:(1)According to LSM value,there were significant differences in CHOL,TG,HDL,GLU,BMI and LSM value among non fibrosis group,mild fibrosis group and significant fibrosis group(P<0.05),in which BMI,CHOL,GLU and LSM value were positively correlated(r>0),HDL,TG and LSM value were negatively correlated(r<0).(2)According to LSM value,there were significant differences in BMI,GLU and LSM value between non fibrosis group and fibrosis group,the difference was statistically significant(P<0.05),and the coefficients were 1.136 and 1.531 respectively.(3)According to the LSM value,they were divided into advanced hepatic fibrosis group and significant liver fibrosis group,and the differences of TG,BMI,GLU and LSM values were statistically significant(P<0.05),and the coefficients were 1.257,1.189 and 2.230;BMI,GLU and LSM values were significantly correlated.Conclusion:BMI and GLU are closely related to LSM of NAFLD,and the progression of liver fibrosis in NAFLD has a certain impact on BMI and GLU;controlling the progression of liver fibrosis in NAFLD patients has a positive significance for improving obesity and abnormal carbohydrate metabolism.