糖尿病合并非酒精性脂肪性肝病患者血清25-羟维生素D水平的变化及其临床意义

发布时间：2018-03-19 21:45

本文选题：糖尿病　切入点：型　出处：《中国糖尿病杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨血清25-羟维生素D[25(OH)D]与T2DM合并非酒精性脂肪性肝病(NAFLD)与糖代谢和相关生化指标的关系,以及其对进展性肝纤维化的影响。方法采集T2DM合并NAFLD患者(NAFLD组,n=380)、单纯T2DM患者(T2DM组,n=130)及体检健康者(NC组,n=130)临床资料及血清25(OH)D,计算NAFLD组肝纤维化评分(NFS),同时测定血糖参数。结果 NAFLD组血清25(OH)D低于T2DM组及NC组[(11.95±6.46)vs(13.95±7.06)vs(18.58±3.71)ng/L,P0.05)]。多元回归分析显示,NAFLD组尿素是25(OH)D的独立保护因素,AST/ALT、24 h尿微量白蛋白(24 hMAU)是其独立危险因素。除NFS公式中所含因素外,25(OH)D、ALT是进展性肝纤维化的独立保护因素,Scr是其独立危险因素。结论与T2DM患者和健康人群比较,T2DM合并NAFLD患者血清25(OH)D更低,且存在更高发生进展性肝纤维化的风险。
[Abstract]:Objective to investigate the relationship between serum 25-hydroxyvitamin D (25-hydroxyvitamin D) and T2DM with nonalcoholic fatty liver disease (NAFLDD), glucose metabolism and related biochemical indexes. Methods the clinical data of patients with T2DM combined with NAFLD (n = 380), simple T2DM (n = 130) and normal control (NC) (n = 130) were collected and the serum 25 OHH D was collected. The hepatic fibrosis score of NAFLD group was calculated and the blood glucose was measured at the same time. Results the serum 25 OHH D in NAFLD group was lower than that in T2DM group and NC group [11.95 卤6.46 VSD 13.95 卤7.06 ng / L P 0.05]. Multivariate regression analysis showed that urea was the independent protective factor of 25 OHH D in NAFLD group. SCR is an independent protective factor for progressive hepatic fibrosis. Conclusion compared with the patients with T2DM and healthy people, the serum level of T2DM with NAFLD is lower than that of T2DM with NAFLD. And there is a higher risk of progressive liver fibrosis.
【作者单位】：遵义医学院附属医院内分泌科;黔东南州人民医院儿科;
【基金】：国家自然科学基金(81560147) 贵州省科技攻关项目[黔科合SY字(2012)3116号] 贵州省科学技术基金[黔科合J字LKZ(2013)53号] 遵义医学院博士启动基金(F-588)
【分类号】：R575.5;R587.1

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