标题：健康体检人群血清25-羟基维生素D水平与非酒精性脂肪肝的关系

      作者：黄金华，鲁翠红    北京市中关村医院健康管理中心，北京 100190

      卷次： 2019年30卷2期

      【摘要】 目的 探讨北京地区健康体检人群血清25羟基维生素Ｄ[(25(OH)D)]与非酒精性脂肪肝(NAFLD)的相关性，为脂肪肝的预防提供参考依据。方法 将2014年1月至2018年1月于北京市中关村医院健康管理中心体检的 1 430例受试者纳入研究，按照有无非酒精性脂肪肝分为健康对照组(NC组) 420例及非酒精性脂肪肝组(NAFLD组) 1 010例，对所有受试者进行问卷调查、体格检查、腹部超声及血液生化指标检测，采用双抗体夹心酶联免疫吸附实验(ELISA)法检测血清25(OH)D浓度，比较两组受试者的基本特征[腰围(WC)、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)]及代谢指标[尿酸(UA)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)低密度脂蛋白胆固醇(LDL-C)]，采用 Spearman相关分析证实 25(OH)D与NAFLD的相关性。此外，将NAFLD组按照病变程度分为轻度NAFLD组(750例)及中+重度NAFLD组(260例)，将其与NC组 25(OH)D水平比较。结果 两组受试者的WC、SBP、DBP、UA、TC水平比较差异均无统计学意义(P>0.05)；NAFLD组受试者的BMI、TG、LDL-C、FBG水平均高于NC组，血清25(OH)D及HDL-C水平低于NC组，差异均有统计学意义(P<0.05)；NAFLD组受试者肥胖、腹型肥胖、高血压、糖尿病、高甘油三酯，代谢综合征患病率均高于NC组，差异均有统计学意义(P<0.05)；25(OH)D水平与 NAFLD呈显著负相关 (r=-0.091，P=0.004)。与 NC组相比，轻度 NAFLD组及中+重度NAFLD组的 25(OH)D水平均下降，中+重度NAFLD组 25(OH)D水平低于轻度NAFLD组，差异均有统计学意义(P<0.05)。结论 NAFLD患者存在25(OH)D缺乏，且低25(OH)D水平与NAFLD显著相关。
      【关键词】 非酒精性脂肪肝；25羟基维生素Ｄ；维生素D缺乏；糖尿病；胰岛素抵抗
      【中图分类号】 R575.5 【文献标识码】 A 【文章编号】 1003—6350（2019）02—179—04C

orrelation between serum 25(OH)D level and nonalcoholic fatty liver disease in healthy physical examinationpopulation.
HUANG Jin-hua, LU Cui-hong. Health Management Center, Beijing Zhongguancun Hospital, Beijing 100190,CHINA
【Abstract】 Objective To explore the correlation between serum 25-hydroxyvitamin D, 25(OH)D, and non-al-coholic fatty liver disease (NAFLD) in healthy people in Beijing, and to provide reference for prevention of fatty liver.Methods A total of 1 430 subjects who underwent physical examination in the Health Management Center at BeijingZhongguancun Hospital from January 2014 to January 2018 were enrolled in this study. According to the presence or ab-sence of nonalcoholic fatty liver, they were divided into a health control group (NC group, 420 cases) and a non-alcohol-ic fatty liver disease group (NAFLD group, 1 010 cases). All subjects were investigated by questionnaire, physical exami-nation, abdominal ultrasound and blood biochemical parameters examination. Serum concentration of 25(OH)D was de-termined by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The difference about the basic fea-tures (waist circumference [WC], body mass index [BMI], systolic blood pressure [SBP], diastolic blood pressure[DBP]) and metabolic indicators (uric acid [UA], fasting plasma glucose [FPG], triacylglycerol [TG], total cholesterol[TC], high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C]) between the twogroups were compared. Correlation between 25(OH)D and NAFLD was confirmed by Spearman correlation analysis. Inaddition, the NAFLD group was divided into mild NAFLD group (750 cases) and moderate-to-severe NAFLD groups