橙皮苷对老年非酒精性脂肪性肝病患者肝脏脂肪变性和炎症的干预研究

Interventional study on the effects of hesperidin on hepatic steatosis and inflammation in elderly patients with non-alcoholic fatty liver disease

目的:探究橙皮苷对老年非酒精性脂肪性肝病(NAFLD)患者肝脏脂肪变性和炎症的干预效果。方法:选取2021年3月至2023年3月定期体检的老年NAFLD患者120例,根据随机数字表法将患者分为2组,每组60例。研究组患者在生活方式干预(控制饮食和运动)的基础上给予橙皮苷胶囊,对照组患者在生活方式干预的基础上给予安慰剂(淀粉)胶囊。采用全自动生化分析仪测定患者的生化指标,采用FibroScan检测患者受控衰减参数(CAP)及肝脏弹性测定值(LSM),采用ELISA试剂盒测定患者超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、核因子κB(NF-κB)。结果:两组患者各指标基线水平差异无统计学意义(P>0.05)。与基线水平比较,研究组患者12周后CAP、丙氨酸氨基转移酶(ALT)、γ谷氨酰转肽酶(GGT)、空腹血糖(FPG)、空腹胰岛素(FIns)、稳态模型胰岛素抵抗指数(HOMA-IR)、胆固醇(CHOL)水平及hs-CRP、TNF-α、NF-κB水平降低(P<0.05),对照组患者12周后CAP、ALT、FIns、HOMA-IR水平降低,NF-κB水平升高(P<0.05)。与对照组比较,研究组患者12周后CAP、GGT、甘油三酯(TG)、CHOL水平及hs-CRP、TNF-α、NF-κB水平降低(P<0.05)。结论:橙皮苷胶囊减轻了NAFLD患者肝脏脂肪变性程度,降低了肝脏部分酶水平、脂质分布及炎症水平,可作为NAFLD患者潜在的补充治疗药物。

Objective:To investigate the effect of hesperidin intervention on hepatic steatosis,biochemical and inflammatory parameters in elderly patients with non-alcoholic fatty liver disease(NAFLD).Methods:A total of 120 elderly patients with NAFLD who underwent regular medical checkups in our hospital from March 2021 to March 2023 were studied,and the patients were divided into 2 groups of 60 patients each according to the random number table method.The study group was given Hesperidin capsules on the basis of lifestyle intervention(controlled diet and exercise)and the control group was given placebo(starch)capsules on the basis of lifestyle intervention.Fully automatic biochemical analyzer was used to determine the biochemical indexes of the patients,FibroScan was used to detect the patients'controlled attenuation parameters(CAP)and liver elastometry(LSM),and ELISA kit was used to determine the patients′ultrasensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and nuclear factor-κB(NF-κB).Results:There was no significant difference between the baseline levels of the indicators in the two groups(P>0.05).Compared with baseline levels,patients in the study group had lower levels of CAP,alanine aminotransferase(ALT),gamma glutamatergic aminotranspeptidase(GGT),fasting glucose(FPG),fasting insulin(FIns),homeostasis model assessment method-insulin resistance index(HOMA-IR),cholesterol(CHOL)and levels of hs-CRP,TNF-αand NF-κB after 12 weeks(P<0.05).In contrast,compared with baseline levels,control patients had lower CAP,ALT,FIns and HOMA-IR levels and higher NF-κB levels after 12 weeks(P<0.05).In addition,CAP,GGT,triglyceride(TG)and CHOL levels and hs-CRP,TNF-αand NF-κB levels were reduced in patients in the study group after 12 weeks compared with the control group(P<0.05).Conclusion:Hesperidin supplementation reduced the degree of hepatic steatosis and decreased the levels of some liver enzymes,lipid distribution,and inflammation in NAFLD patients and may serve as a potential complementary therapeutic agent for NAFLD patients.