非酒精性脂肪性肝病患者血清铁蛋白与免疫功能的关系

Correlation of serum ferritin and immune function in patients with nonalcoholic fatty liver disease

[目的]探讨非酒精性脂肪性肝病(NAFLD)患者血清铁蛋白(SF)水平与外周血T淋巴细胞亚群及炎症细胞因子的相关性。[方法]将入选的171例NAFLD患者,分为单纯脂肪肝(NAFL)组(80例),非酒精性脂肪性肝炎(NASH)组(91例),另选择健康体检者80例为对照组。比较各组SF、炎症细胞因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)、外周血辅助性T淋巴细胞17(Th17)和调节性T淋巴细胞(Treg)水平,分析SF与炎症细胞因子及T淋巴细胞亚群的相关性。[结果]NAFL组和NASH组SF、IL-6、TNF-α、Th17及Th17/Treg水平均高于对照组,NASH组Treg水平则低于NAFL组和对照组(P<0.05);NASH组SF、IL-6、TNF-α、Th17及Th17/Treg水平亦高于NAFL组(P<0.05)。相关性分析显示,SF与IL-6、TNF-α、Th17/Treg水平呈正相关(P<0.05)。[结论]NAFLD患者存在SF、炎症因子水平升高及Th17/Treg比例失衡,SF水平升高可能介导了NAFLD免疫失衡和炎症反应。

[Objective]To investigate the correlation of serum ferritin(SF)level and peripheral blood T lymphocyte subsets and cytokines in patients with nonalcoholic fatty liver disease(NAFLD).[Methods]A total of 171 patients with NAFLD were enrolled this study and divided into nonalcoholic fatty liver(NAFL)group(80 cases)and non-alcoholic steatohepatitis(NASH)group(91 cases),and another 80 healthy volunteers were selected as the control group.The levels of SF,peripheral blood helper T lymphocytes 17(Th17),regulatory T lymphocytes(Treg),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared among three groups.The correlation of SF with T lymphocyte subsets,IL-6 and TNF-α was analyzed.[Results]The levels of SF,IL-6,TNF-α,Th17 and Th17/Treg in NAFL and NASH groups were all higher than those in the control group,while the levels of Treg were all lower than those in the control group(P<0.05).The levels of SF,IL-6,TNF-α,Th17 and Th17/Treg in NASH group were also higher than those in NAFL group,and the level of Treg was lower than that in NAFL group(P<0.05).SF was positively correlated with IL-6,TNF-α and Th17/Treg(P<0.05).[Conclusion]The patients with NAFLD show elevated levels of SF,inflammatory factors and imbalance of Th17/Treg ratio.SF may promote the inflammatory response and immune imbalance of NAFLD.