血清铁蛋白与非酒精性脂肪性肝病的相关性研究

目的　研究血清铁蛋白（Serum ferritin，SF）与非酒精性脂肪性肝病（Nonalcoholic fatty liver disease, NAFLD）的相关性并评价SF对NAFLD的诊断价值。方法　测定327 例经腹部超声确诊的NAFLD 患者和239 名正常对照者的人体学参数及血液学指标，包括体重指数、收缩压、舒张压、SF、丙氨酸氨基转移酶、总蛋白、白蛋白、血糖、γ-谷氨酰基转移酶、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、尿酸、肌酐、血红蛋白、血小板和白细胞。采用Spearman 相关性分析评价SF与其他变量之间的相关性；采用逻辑回归分析评估SF与NAFLD的关联；采用ROC曲线分析SF的NAFLD的诊断价值。结果 与正常对照组比较，NAFLD 组SF水平明显升高（P<0.001）；NAFLD患者ALT异常组（ALT>40 U/L）SF水平显著高于ALT正常患者。相关分析显示SF与TP、ALB、ALT、GGT、TG、Glu、UA、Cr和Hgb均正相关(P均<0.05),而与HDL-c呈负相关(P<0.001)。逻辑回归分析显示SF水平是预测NAFLD发生的独立危险因素 比值比（OR）=1.015，95% 可信区间（CI）：1.013-1.022，p<0.001]。ROC曲线分析发现，SF（男）的ROC曲线下面积AUC为0.905（0.873-0.932）,敏感度为90.04%，特异度性为83.82%；SF（女）的ROC曲线下面积AUC为0.875（0.812-0.923）,敏感度为79.07%，特异度为87.88%。 结论 NAFLD患者SF水平明显升高,SF是NAFLD发生的独立危险因素,SF与肝脏损伤相关。

The association between serum ferritin and non-alcoholic fatty liver disease

Objective To investigate the association between Serum ferritin (SF) and Nonalcoholic fatty liver disease (NAFLD) and evaluate the diagnostic value of SF for NAFLD. Method The human parameters and hematology indexes of 327 NAFLD patients via abdominal ultrasound diagnosis and 239 normal controls were detected, indexes including body mass index, systolic pressure, diastolic pressure, SF, alanine aminotransferase, total protein, albumin, fasting plasma glucose , gamma pancreatic acyltransferase, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol , uric acid, creatinine, hemoglobin, platelet and white blood cells. Spearman correlation analysis was used to evaluate the correlation between SF and other variables. Logistic regression was used to evaluate the correlation between SF and NAFLD. ROC curve was used to analyze the diagnostic value of SF for NAFLD. Results Compared with the control group, the SF level of NAFLD group was significantly increased (P<0.001). NAFLD Patients with high ALT (ALT>40 U/L) were significantly higher than that with ALT normal. Correlation analysis showed that SF was positively correlated with TP, ALB, ALT, GGT, TG, Glu, UA, Cr and Hgb (P< 0.05), and negatively correlated with HDL-c (P<0.001). Logistic regression analysis showed that SF was an independent risk factor for predicting the occurrence of NAFLD ratio (OR) =1.015, 95% confidence interval (CI) : 1.013-1.022, p<0.001]. The ROC curve analysis found that the area under the ROC curve of SF (male) was 0.905 (0.873-0.932), the sensitivity was 90.04% and specificity was 83.82%. The area under the ROC curve of SF (female) was 0.875 (0.812-0.923), and the sensitivity was 79.07% and the specificity was 87.88%. Conclusion the SF level of NAFLD patients was significantly increased, SF is an independent risk factor for NAFLD, SF was associated with liver damage.