2型糖尿病合并代谢相关脂肪性肝病患者与血清25-羟维生素D水平变化的相关性研究

Correlation between Patients with Type 2 Diabetes Mellitus Combined with Metabolic-related Fatty Liver Disease and Changes in Serum 25-hydroxyvitamin D Levels

目的探究2型糖尿病合并代谢相关脂肪性肝病患者与血清25-羟维生素D[25-hydroxyvitamin D,25(OH)D]之间的关系。方法回顾性分析2020年2月—2022年2月于上海市徐汇区大华医院就诊的2型糖尿病合并代谢相关脂肪性肝病患者(MAFLD组,n=60)、2型糖尿病患者(DM组,n=60)及体检健康者(NC组,n=60)的临床基线资料及血清25(OH)D值。结果NC组、DM组以及MAFLD组患者性别、年龄、Ur以及TC比较,差异无统计学意义(P>0.05),MAFLD患者的AST/ALT水平低于DM组和NC组患者,NC组血清25(OH)D水平高于DM组MAFLD组,且DM组高于MAFLD组,差异有统计学意义(P<0.05);MAFLD组血清25(OH)D与各变量进行相关性分析,其中25(OH)D与Ur呈正相关,与AST/ALT和24UAMLB呈负相关(P<0.05);以MAFLD组血清25(OH)D为因变量,以Ur、AST/ALT以及24UAMLB为自变量进行多元线性回归分析,结果显示Ur为25(OH)D的保护因素,AST/ALT和24UAMLB为25(OH)D的危险因素。结论2型糖尿病合并代谢相关脂肪性肝病患者中血清维生素D水平显著低于糖尿病患者和健康体检者,密切监测患者血清25(OH)D水平有助于临床评估2型糖尿病患者合并代谢相关脂肪性肝病的风险,尽可能避免发生进展性肝纤维化的发生概率。

Objective To investigate the relationship between patients with type 2 diabetes mellitus combined with metabolic-related fatty liver disease and serum 25-hydroxyvitamin D(25(OH)D).Methods Clinical baseline data and serum 25(OH)D were retrospective analysedof patients with type 2 diabetes combined with metabolic-related fatty liver disease(MAFLD group,n=60),type 2 diabetes mellitus(DM group,n=60)and physically healthy individuals(NC group,n=60)who came to Shanghai Xuhui District Dahua Hospital from February 2020 to February 2022.Results There were no statistically significant differences in gender,age,Ur and TC between the NC,DM and MAFLD groups(P>0.05).The AST/ALT levels in the MAFLD patients were lower than that in the DM and NC groups,serum 25(OH)D level in the NC group was significantly higher compared with the MAFLD group and the DM group,and the DM group was higher than the MAFLD group,and the difference was statistically significant(P<0.05).The MAFLD group serum 25(OH)D was correlated with each variable,where 25(OH)D was positively correlated with Ur and negatively correlated with AST/ALT and 24UAMLB(P<0.05).Multiple linear regression analysis was performed with serum 25(OH)D as the dependent variable and Ur,AST/ALT,and 24UAMLB as independent variables in the MAFLD group,and the results showed that Ur was a protective factor for 25(OH)D,and AST/ALT and 24UAMLB were risk factors for 25(OH)D.Conclusion Serum vitamin D levels were significantly lower in patients with type 2 diabetes combined with metabolic-associated fatty liver disease than in diabetic patients and healthy subjects,and close monitoring of serum 25(OH)D levels in patients would help to clinically assess the risk of type 2 diabetes combined with metabolic-associated fatty liver disease and avoid the probability of progressive liver fibrosis as much as possible.