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中国临床研究英文版:2023,36(5):670-674
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2型糖尿病合并非酒精性脂肪性肝病患者维生素D水平与肝纤维化的关系
(北部战区总医院内分泌科,辽宁 沈阳 110016)
Correlation between 25 Hydroxyvitamin D level and liver fibrosis in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease
(Department of Endocrinology, General Hospital of the Northern Theater, Shenyang, Liaoning 110016, China)
摘要
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Received:May 26, 2022   Published Online:May 20, 2023
中文摘要: 目的 分析2型糖尿病(T2DM)患者的血清25-羟基维生素D[25-(OH)D]水平,探讨其与非酒精性脂肪性肝病(NAFLD)的相关性。方法 纳入2020年10月至2021年10月入住北部战区总医院且资料齐全的536例T2DM患者,其中无NAFLD患者218例,NAFLD患者318例,比较无NAFLD患者和NAFLD患者25-(OH)D水平。采用NAFLD纤维化评分(NFS)和脂肪肝指数(FLI)对T2DM并发NAFLD患者进行分组,比较是否肝纤维化患者血清25-(OH)D的差异。采用多元logistic回归分析T2DM并发NAFLD患者的肝纤维化的独立影响因素。结果 NAFLD患者PTH、腰围、TG、AST、ALT、BMI高于无NAFLD患者,25-(OH)D、β-CTX、血磷水平显著低于无NAFLD患者(P<0.05)。采用NFS和FLI评分分亚组,肝纤维化亚组25-(OH)D水平显著低于无肝纤维化亚组(P<0.05)。Logistic回归分析显示,25-(OH)D、腰围是T2DM并发NAFLD患者肝纤维化的独立影响因素(P<0.05)。结论 T2DM合并NAFLD患者血清25-(OH)D水平显著降低,较低的25-(OH)D水平可能表明T2DM患者发生NAFLD的风险增加。
Abstract:Objective To observe the level of serum 25-hydroxyvitamin D [25-(OH)D]level in patients with type 2 diabetes(T2DM) to explore its association with nonalcoholic fatty liver disease(NAFLD) in T2DM patients. Methods A total of 536 patients with T2DM who were admitted to the General Hospital of the Northern Theater from October 2020 to October 2021 were enrolled, including 218 patients without NAFLD(non-NAFLD group) and 318 patients with NAFLD(NAFLD group). The 25-(OH)D levels were compared between two groups. NAFLD fibrosis score(NFS) and fatty liver index(FLI) were used to classify patients with T2DM complicated by NAFLD, and the serum 25-(OH)D levels were compared in the patients with different degrees of liver fibrosis. The multiple logistic regression analysis was performed to analyze the independent influencing factors of liver fibrosis in T2DM patients. Results The levels of parathyroid hormone、waist circumference(WC), TG, AST, ALT, BMI in NAFLD group were significantly higher than those in non-NAFLD group(P<0.05), and the levels of 25-(OH)D, beta C-terminal telopeptide(β-CTX) and blood phosphorus were significantly lower than those in non-NAFLD group(P<0.05). The levels of 25-(OH)D in the hepatic fibrosis subgroups were significantly lower than those in the non-hepatic fibrosis subgroups according to NFS and FLI scores (P<0.05). It was suggested that 25-(OH)D and WC were independent influencing factors of liver fibrosis in T2DM patients complicated with NAFLD(P<0.05). ConclusionIn T2DM patients complicated with NAFLD, the serum 25-(OH)D level obviously reduces, which may be indicative of the increased risk of liver fibrosis in the patients.
文章编号:     中图分类号:R587.2 R575.5    文献标志码:A
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