血清胆红素水平与非酒精性脂肪性肝病的关系研究

目的探讨血清胆红素水平与非酒精性脂肪性肝病(NAFLD)的关系。方法以2013年1月-2013年6月在新疆医科大学第五附属医院进行健康体检者为研究对象,从中筛查出NAFLD患者462例,按年龄、性别配对的方法选取健康对照者462例,测量两组身高、体质量、血压、总胆红素、直接胆红素、间接胆红素、丙氨酸转氨酶、天冬氨酸转氨酶、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、空腹血糖、尿酸等指标,t检验比较两组上述指标差异,多因素Logistic回归分析NAFLD患病影响因素。结果与对照组相比,NAFLD组体质量指数、收缩压、舒张压、丙氨酸转氨酶、天冬氨酸转氨酶、三酰甘油、总胆固醇、空腹血糖和尿酸水平明显升高(P0.01),总胆红素、直接胆红素、间接胆红素水平明显降低(P0.01);随着体质量指数(OR=1.363,P0.01)、舒张压(OR=1.040,P0.01)、丙氨酸转氨酶(OR=1.038,P0.01)、三酰甘油(OR=1.399,P0.01)、空腹血糖(OR=1.865,P0.01)和尿酸(OR=1.006,P0.01)水平上升,NAFLD发生的风险增加;随着总胆红素水平升高,NAFLD的发生风险降低(OR=0.897,P0.01)。结论血清胆红素与NAFLD的发生密切相关,血清胆红素水平下降将导致NAFLD发生的风险增加。

Relationship between serum bilirubin level and non-alcoholic fatty liver disease

Objective To investigate the relationship between serum bilirubin level and non-alcoholic fatty liver dis- ease （NAFLD）. Methods Four hundred and sixty-two patients with NAFLD and 462 healthy controls were selected from the healthy physical examinees from Jan. 2013 to Jun. 2013 were enrolled into this study. The differences in height, weight, blood pressure, total serum bilirubin, direct blirubin, indirect bilirubin, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, triglyceride （TG）, total cholesterol （TC）, fasting blood glucose, uric acid were compared between two groups and the correlation between serum bilirubin and NAFLD was analyzed. Results The body mass index, blood pressure, ALT, AST, TG, TC, fasting blood glucose, uric acid of the NAFLD group were high- er than those of the control group （P 〈 0.01 ） ; total serum bilirubin, direct blirubin, indirect bilirubin of the NAFLD group were lower than those of the control group （P 〈 0.01 ） ; the increase in the risk of NAFLD was related to the de- crease of total serum bilirubin level （ OR = O. 897, P 〈 0.01 ）. Conclusion Total serum biliruhin level is related to NAFLD. As total serum bilirubin level decreases, the risk of NAFLD tends to increase.