A U‐shaped association between serum albumin with total triiodothyronine in adults

BackgroundThyroid dysfunction is a common thyroid disorder in our life and its symptoms are non‐specific, therefore the diagnosis of thyroid dysfunction is important for patients. Albumin (ALB) can carry thyroid hormones to their sites of action as a way to achieve rapid delivery of thyroid hormones to the tissues. The purpose of this study was to investigate the relationship between serum ALB levels and total triiodothyronine (TT3) in adults.MethodsData from the 2007–2012 National Health and Nutrition Examination Survey (NHANES) were used to examine the association between ALB and TT3 using multivariate logistic regression models. Fitting smoothed curves and generalized weighted models were also used.ResultsThe analysis included a total of 7933 participants that we found an independent positive relationship between ALB and TT3 among participants [0.006 (0.003, 0.009)]. In men, there was a significant positive correlation between ALB and TT3, whereas in women ALB and TT3 suggested a significant negative correlation. Moreover, our study revealed that the independent association between the levels of ALB and TT3 was significant in Non‐Hispanic White, but not in Non‐Hispanic Black. Notably, we found a U‐shaped association between ALB and serum TT3 in total participants (inflection point for ALB: 41 g/L) and females after adjusted covariates (inflection point for ALB: 46 g/L).ConclusionsWe found a U‐shaped relationship between serum ALB and TT3 with infection point at 41 g/L for ALB, which may provide a reference for future screening in adults with thyroid dysfunction.     

血清铁蛋白水平与非酒精性脂肪肝及相关危险因素关系

目的分析体检人群血清铁蛋白水平与非酒精性脂肪肝及其相关危险因素的关系。方法单纯非酒精性脂肪肝患者222例为观察组,体检健康者192例为对照组,检测2组血脂指标、体质量指数、血压、肝功能、空腹血糖、血尿酸等,并行肝脏B超检查,测定血清铁蛋白水平,分析其与上述指标的相关性。结果观察组体质量指数、收缩压、男性舒张压、空腹血糖、血尿酸、三酰甘油、总胆固醇、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、谷氨酸转肽酶及铁蛋白水平均高于对照组（P〈0．05）,高密度脂蛋白胆固醇低于对照组（P〈0．05）;血清铁蛋白水平与谷氨酸转肽酶、舒张压、血尿酸、空腹血糖呈正相关（P〈0．05）。结论血清铁蛋白水平增高是引起非酒精性脂肪肝危险因素之一。     

血清铁蛋白对非酒精性脂肪肝患者早期肝纤维化的诊断价值

目的研究血清铁蛋白(SF)对非酒精性脂肪肝(NAFLD)患者早期肝纤维化的诊断价值。方法随机选取104例NAFLD患者和60例健康人进行血清学、肝脏B超和SF检查。NAFLD患者行肝脏活组织检查。分析并评价SF对NAFLD患者早期肝纤维化的诊断价值。结果 NAFLD患者的丙氨酸氨基转移酶(ALT)、γ-谷氨酰转移酶(GGT)、总胆固醇(TC)、三酰甘油(TG)、透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原氨基端肽(PⅢNP)、Ⅳ型胶原(CⅣ)、SF均高于健康对照组,差异有统计学意义(P0.05)。0期肝纤维化患者的HA、CⅣ和SF小于早期患者,差异有统计学意义(P0.05)。在早期患者中,相关性分析显示SF水平与HA、CⅣ呈正相关(rHA=0.44,rCⅣ=0.53,P0.05)。ROC曲线发现SF对早期肝纤维化患者的诊断曲线下面积为0.688(P=0.005),当SF为93μg/L时,诊断的灵敏度为73%,特异性为67%。结论血清SF的升高能够反映NAFLD患者早期肝纤维化的变化,有望成为NAFLD早期肝纤维化的血清学辅助诊断指标。     

Association between apolipoprotein E gene polymorphism and nonalcoholic fatty liver disease in Southern China: A case‐control study

BackgroundApolipoprotein E (ApoE) polymorphisms have been reported to be associated with nonalcoholic fatty liver disease (NAFLD), but the conclusions of studies are inconsistent in different regions. The present study aims to investigate the role of ApoE genotypes on NAFLD in southern China.MethodsA total of 1064 subjects including 372 NAFLD patients and 692 controls who attended Meizhou People''s Hospital located in southern China from March 1, 2016 to April 30, 2020 were enrolled in this study. The ApoE genotypes were detected and the laboratory parameters were examined.ResultsSignificant differences were observed between NAFLD patients and controls in the prevalence of ε3/ε3 (p < 0.001) and ε3/ε4 (p = 0.004). NAFLD patients presented higher frequency of ε4 allele than controls (p = 0.013). Logistic regression analysis suggested that ε3/ε3 was an independent risk factor (OR: 1.435, 95% CI: 1.084–1.891, p = 0.010), while ε3/ε4 was an independent protective factor (OR: 0.578, 95% CI: 0.404–0.828, p = 0.003) for development of NAFLD. In addition, allele ε4 showed a protective effect on NAFLD with an adjusted OR of 0.588 (95% CI: 0.420–0.824, p = 0.002).ConclusionOur results suggested that ApoE genotype was associated with the development of NAFLD in the population of southern China. Individuals carrying ε3/ε3 were at higher risk of NAFLD, while those carrying ε3/ε4 were at lower risk of NAFLD.     

Relationship between serum ferritin,iron stores and disease activity in rheumatoid arthritis

Summary Bone marrow aspirate from the sternum of 40 patients with active or inactive rheumatoid arthritis (RA) was stained with Perls’ Prussian blue for iron determination. In these patients serum ferritin concentrations were correlated with other indices of iron stores and disease activity. In patients with active RA and without bone marrow iron stores, serum ferritin was significantly lower than in patients with either active or inactive RA and iron stores. In patients with bone marrow iron stores, serum ferritin was directly correlated with erythrocyte sedimentation rate (ESR), Ritchie index, α₁-antitrypsin, α₁-acid glycoprotein and desferrioxamine (DFO)-induced sideruria, while an inverse correlation of serum ferritin with hemoglobin and serum iron was observed. In all patients serum ferritin was significantly correlated only with DFO-induced sideruria and unsaturated iron-binding capacity (UIBC). Thus, serum ferritin is an index of iron stores also in rheumatoid arthritis. In active disease, higher than expected values of serum ferritin are probably due to a shifting of iron from the circulating pool to the reticuloendothelial cells of the synovial membrane.     

血清铁蛋白及游离脂肪酸与妊娠期糖尿病胰岛素抵抗的相关性研究

目的：探讨血清铁蛋白（SF）及游离脂肪酸（FFA）与妊娠期糖尿病（GDM）患者胰岛素抵抗（IR）的关系,为早期干预GDM的发生发展提供依据。方法：2011年1月至2013年10月,以同期GDM组（71例）、正常孕妇组（50例）及正常非孕组（50例）为研究对象。同时检测空腹血清SF（电化学发光免疫法）、FFA（酶联法）、血糖（FBG）及胰岛素（Fins）水平[FBG,Fins,计算胰岛素抵抗指数（HOMA—IR）值1,并进行统计学分析。结果：正常非孕组、正常孕妇组及GDM组,三组血清sF水平（119．57±22．04,197．81±46．32,388．79±91．67）依次升高,且相差显著（F=57．543,P〈0．01）,GDM组显著高于正常孕妇组（t=9．826,P〈0．01）;三组血清FFA水平（0．43±0．18,0．67±0．14,1．03±0．21）依次升高,且相差显著（F=37．619,P〈0．01）,GDM组显著高于正常孕妇组（t=6．004,P〈0．01）;三组HOMA—IR值（1．83±0．45,2．92±0．87,3．94±1．02）依次升高,且相差显著（F=45．071,P〈0．01）,GDM组显著高于正常孕妇组（t=11．183,P〈0．01）。GDM患者空腹血清SF、FFA水平分别与HoMA—IR值呈显著正相关（r=O．832、0．759,P〈0．01）,空腹血清FFA水平与sF水平也呈显著正相关（r=0．893,P〈0．01）,其相关性良好。结论：妊娠期糖尿病患者体内存在着高铁蛋白、游离脂肪酸血症及胰岛素抵抗状态,血清铁蛋白和游离脂肪酸水平与胰岛素抵抗相关,此为早期干预妊娠期糖尿病的发生发展提供了理论依据。     

血清铁含量检测在酒精性脂肪性肝病和非酒精性脂肪性肝病中的临床意义

目的：探讨铁代谢相关血清学指标在酒精性脂肪性肝病(ALD)和非酒精性脂肪性肝病(NAFLD)中的意义及在肝损伤过程中的作用。方法脂肪性肝病患者406例,其中 ALD 组198例,NAFLD 组208例,另选健康对照组96例,检测血清铁(SF)、铁蛋白(Ferr)及转铁蛋白(TRF)。结果 NAFLD 组、ALD 组 SF、Ferr 水平均高于健康对照组(P <0.05);且 NAFLD 组 SF、Ferr 水平高于 ALD 组。NAFLD 组、ALD 组 TRF 水平均低于健康对照组(P <0.05);且 NAFLD 组 Ferr 水平低于 ALD 组。NAFLD、ALD 组肝硬化亚组血清 SF、Ferr 明显高于肝炎亚组(P <0.05),TRF 明显低于肝炎亚组,差异均有统计学意义(P <0.05)。结论 SF、Ferr 和 TRF 有助于了解脂肪性肝病患者肝损伤程度,特别是对 NAFLD 的预后有重要意义。     

肝脏瞬时弹性成像和超声诊断参数在脂肪肝诊断及病情程度评估中的应用价值

目的  探究肝脏瞬时弹性成像和超声诊断参数在脂肪肝诊断及病情程度评估中的应用价值。 方法  选择2019年1月1日~ 2021年3月1日于我院确诊为脂肪肝的120例患者作为观察组,并选取同时期健康体检者50例作为对照组,均行肝脏彩色多普勒超声及瞬时弹性成像检查。根据肝脏常规检查(肝脏大小、肝实质回声)结果对观察组患者进行病情程度评估,将患者分为轻度组(n=54)、中度组(n=44)和重度组(n=24),分别比较4组BMI、皮下脂肪层厚度、肝组织声速值、肝脏硬度值,采用Kappa一致性检验分析肝脏瞬时弹性成像与彩色多普勒超声诊断脂肪肝结果一致性,线性趋势卡方检验分析肝脏瞬时弹性成像与彩色多普勒超声诊断脂肪肝的相关性。 结果  对照组、轻度组、中度组、重度组患者BMI、皮下脂肪层厚度、肝脏硬度值依次增加,中度组、重度组患者肝组织声速值依次降低(P < 0.05),对照组、轻度组、中度组患者肝组织声速值差异无统计学意义(P>0.05);肝脏瞬时弹性成像与彩色多普勒超声诊断脂肪肝结果一致性良好(Kappa=0.67,P < 0.05);肝脏瞬时弹性成像与彩色多普勒超声诊断脂肪肝相关性有统计学意义,且肝脏瞬时弹性成像对于轻、中度脂肪肝区分度高于彩色多普勒超声(总变异χ²=298.25,线性回归分量χ²=203.47,偏离线性回归分量χ²=91.43,P < 0.05)。 结论  肝脏瞬时弹性成像和超声诊断脂肪肝一致性良好,但肝脏瞬时弹性成像可更精细区分病情程度。     

我国成人血清ALP与非酒精性脂肪肝和代谢综合征的相关性

目的 探讨中国成人的血清碱性磷酸酶（ALP）与非酒精性脂肪肝（NAFLD）和代谢综合征（MS）的相关性。 方法 回顾性调查2009年1~ 12月我院健康体检人员,排除急性肝损伤、HBV感染、HCV感染、肾脏病、充血性心力衰竭、骨骼疾病患者及饮酒、吸烟、怀孕的调查对象,共计2 638例（男性2 010例,女性628例,年龄19~92岁）。用B型超声诊断脂肪肝。用美国国家胆固醇教育计划成人治疗方案第三次报告(NCEP-ATPⅢ) 的中国人修订标准诊断MS。 结果 男、女性NAFLD患病率分别为28.0%和21.8%（P<0.01）,MS为40.1%和32.6%（P<0.01）。控制年龄和肝酶,多变量logistic分析显示性别与NAFLD与MS皆显著相关。按年龄分层显示,女性ALP水平从45岁~64岁随年龄增加显著升高,男性ALP水平从19岁～92岁随年龄增加轻微下降,变化不明显。单变量logistic回归分析显示,女性ALP与NAFLD和MS皆有显著相关性（P<0.001）;男性ALP与NAFLD和MS皆无显著相关性（P>0.05）;ROC曲线显示：女性血清ALP筛检NAFLD的cut off值是57.1 U/L,MS是57.0 U/L。 结论 ALP可作为筛检女性NAFLD和MS的一个新的共同标志物,女性绝经可能是女性血清ALP与NAFLD和MS显著相关的核心原因,其确切机制尚待研究。     

血清脂联素水平与非酒精性脂肪性肝病相关性研究

目的 研究北京市成人非酒精性脂肪肝（NAFLD）患者血清脂联素水平的变化特点并对其相关因素进行分析.方法 通过随机多级分层整群抽样对2007～ 2008年北京市东城区和通州区各4个居委会20岁以上居民进行流行病学调查,按照随机配对的原则,排除其中有高血压、糖尿病、肝硬化的患者.入选NAFLD组435例,平均年龄（45.0±11.4）岁,对照组442例,平均年龄（44.7±11.6）岁,测量受试者的身高、体重、腰围及臀围;抽空腹血测定肝肾功能、肝炎病毒标志物、空腹血糖（FBG）、血脂、空腹胰岛素（FINS）和脂联素;计算体重指数（BMI）及稳态模型胰岛素抵抗指数（HOMA-IR）.采用SPSS 19.0软件进行统计学分析.计量资料采用t检验,脂联素相关因素分析采用Spearman等级相关分析,以P＜0.05为差异有统计学意义,NAFLD的危险因素用多因素非条件Logistic回归分析.结果 （1） NAFLD组体重指数、腰臀比、血压、血糖、血清总胆固醇、甘油三酯、胰岛素水平、低密度脂蛋白胆固醇、HOMA-IR、尿酸较非NAFLD组高（P均＜0.05）,而脂联素、高密度脂蛋白胆固醇（HDL-C）则较对照组低（P均＜0.05）.（2）血清脂联素与BMI、HOMA-IR、腰臀比、血糖、TG、TC、低密度脂蛋白胆固醇（LDL-C）、尿酸呈负相关（r值分别为-0.075,-0.13,-0.185,-0.49,-0.137,-0.008,-0.041,-0.133,P均＜0.05）.（3）采用多因素非条件Logistic回归分析,入选变量包括：腰臀比、BMI、收缩压、舒张压、甘油三酯、LDL-C、HDL-C、尿酸、ALT、血糖、FINS、HOMA-IR、脂联素.结果显示BMI、HOMA-IR、脂联素是NAFLD形成的主要危险因素,回归方程P=1/[1＋e-（-8.734＋0 281BMI＋0.409HOMA-IR-0.19脂联素）].结论 NAFLD患者的特征是体重增加,存在明显胰岛素抵抗,脂联素含量减少.其中血清脂联素水平的下降与NAFLD的发生存在密切的关系.     

血清视黄醇结合蛋白4和非酒精性脂肪性肝病的相关性

目的分析非酒精性脂肪性肝病（NAFLD）患者血清视黄醇结合蛋白4（RBP4）水平,探讨血清RBP4与NAFLD发病的相关性。方法分别测定324例NAFLD患者和200名健康对照者血清RBP4、肌酐（Cr）、三酰甘油（TG）、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）、空腹葡萄糖（Glu）水平,比较各指标在2组中的差异。结果 NAFLD组血清RBP4水平[（58.42±20.74）mg/L]明显高于对照组[（39.1±7.1）mg/L]（P〈0.01）;Logistic回归分析显示血清RBP4是与NAFLD发病相关的独立危险因子（预期比数比为1.138,P〈0.05）,Pearson相关分析提示血清RBP4水平与Cr、TC、TG、LDL-C水平呈正相关（r分别为0.270、0.393、0.175、0.158,P均0.057）,与HDL-C水平呈负相关（r=-0.186,P〈0.05）。结论血清RBP4水平与NAFLD患病相关,并且与Cr、TC、TG、LDL-C、HDL-C具有相关性。     

40例酒精性脂肪肝患者血清酶指标检测分析

目的探讨酒精性脂肪肝(AFID)患者血清酶在病程中的变化规律及临床意义。方法对80例非酒精性脂肪肝(NAFID)、40例AFID、60例非脂肪肝(健康对照组)的血清酶等,进行测定分析。结果 AFID组血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、天门冬氨酸氨基转移酶线粒体同工酶(mAST)、谷氨酸脱氢酶(GLDH)均显著高于健康对照组,差异有统计学意义(P0.01)。AFID组ALT、AST与NAFID组差异无统计学意义(P0.05),但AFID组的mAST、mAST/AST、GGT、GLDH均显著高于NAFID组,差异有统计学意义(P0.01)。结论 ALT、AST、GGT、mAST、GLDH活性测定有助于AFID的评估,有助于AFID的诊断及鉴别,具有重要的临床意义。     

Gamma‐Glutamyl Transpeptidase‐to‐Platelet ratio predicts liver fibrosis in patients with concomitant chronic hepatitis B and nonalcoholic fatty liver disease

ObjectivesThe aim of this study was to compare the correlation of gamma‐glutamyl transpeptidase‐to‐platelet ratio (GPR), aspartate aminotransferase‐to‐platelet ratio index (APRI), fibrosis index‐4 (FIB‐4), and liver stiffness measurement (LSM) in the diagnosis of liver fibrosis, and perform a diagnostic value of GPR for predicting fibrosis in CHB patients with NAFLD.MethodsA retrospective study was conducted on CHB patients concurrent with NAFLD between September 2019 and December 2020. They were divided into control group (LSM ≤ 9.7 kpa) and fibrosis group (LSM ≥ 9.8 kpa). Demographic data were collected; ALT, AST, and PLT were also detected. LSM was measured by transient elastography (TE). The GPR, APRI, and FIB‐4 were calculated. The correlation between GPR, APRI, FIB‐4, and LSM was compared. The accuracy of predicting liver fibrosis using GPR, APRI, and FIB‐4 was assessed.ResultsEighty‐five CHB patients with NAFLD were enrolled. Multivariate analysis showed that age (p = 0.005), GGT (p = 0.001), and PLT (p = 0.013) were the independent risk factors for LSM. The GPR (p = 0.008), APRI (p = 0.001), and FIB‐4 (p = 0.001) values in fibrosis group were higher than control group. Pearson linear correlation was used to analyze the correlations between LSM and GPR, APRI, and FIB‐4. LSM was correlated with GPR, APRI, and FIB‐4. The AUCs of GPR, APRI, and FIB4 were 0.805, 0.766, and 0.826 in assessing liver fibrosis, respectively. No significant differences in the areas of GPR were comparable to that of APRI and FIB‐4.ConclusionGPR has a good correlation with LSM in assessing liver fibrosis and can be used as a noninvasive index for the assessment of liver fibrosis in patients with concomitant CHB and NAFLD.     

非酒精性脂肪肝患者血清游离脂肪酸与胰岛素抵抗的关系

目的研究非酒精性脂肪肝(NAFLD)患者血清游离脂肪酸(FFA)水平及其与胰岛素抵抗(IR)的关系。方法测定118例NAFLD患者(NAFLD组)及103名健康体检者(正常对照组)的血清FFA并计算胰岛素抵抗指数(HOMA-IR)。结果 NAFLD组血清FFA浓度为(752.50±101.42)μmol/L,HOMA-IR为1.48±0.42,均高于正常对照组[(441.75±95.64)μmol/L,0.67±0.33](P<0.01)。NAFLD组FFA与HOMA-IR呈正相关(r=0.325,P<0.05)。结论 FFA与NAFLD密切相关,FFA致NAFLD可能通过IR起作用。     

非酒精性脂肪性肝病患者甲状腺激素水平变化及其与肝纤维化的关系

目的:探讨非酒精性脂肪性肝病(NAFLD)患者血清甲状腺激素水平变化与肝纤维化的关系及其意义。方法:采用放射免疫法检测123例NAFLD患者及56例对照组的血清甲状腺激素(T3、T4、TSH)及透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原氨基末端肽(PⅢNP)、Ⅳ型胶原(CⅣ)等反应肝纤维化的血清学指标。结果:对照组与非酒精性单纯性脂肪肝(NASFL)组、非酒精性脂肪性肝炎(NASH)组血清T3浓度随病情进展逐渐降低,差异有统计学意义(P<0.01);3组间血清T4、TSH浓度比较差异无显著性(P>0.05);NASFL患者血清HA、PⅢNP浓度与较对照组升高,差异有统计学意义(P<0.01),而CⅣ、LN浓度差异无统计学意义(P>0.05);NASH组血清HA、PⅢNP、CⅣ、LN浓度均高于健康对照组及NAFL组,差异有统计学意义(P<0.01);NASFL患者血清T3水平与HA呈负相关关系(P<0.05);NASH组患者血清T3水平与HA、PⅢNP、CⅣ、LN均呈负相关关系(P<0.05)。结论:NAFLD患者血清T3水平降低,其下降程度与病情及肝纤维化严重程度一致;检测NAFLD患者血清T3变化对判断病情及预后有一定的临床价值。     

The effect of melatonin supplementation on liver indices in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis of randomized clinical trials

Several randomized clinical trials (RCTs) evaluated the effect of melatonin supplementation on liver enzymes in patients with non-alcoholic fatty liver disease (NAFLD) and reported conflicting results. To meet these discrepancies, a meta-analysis was conducted to evaluate the eff ;ect of melatonin on liver indices in patients with NAFLD. To collect the required data, a thorough search was conducted through Web of science, Pubmed, Cochrane database, Embase, Google Scholar, ProQuest, and Scopus databases. The aim was to find clinical trials over the effect of melatonin supplementation on liver indices up to 16 May 2019. As a result, five eligible articles were selected and analysed in this meta-analysis using a fixed-effects model. Heterogeneity test was performed by I² statistics and Cochrane Q test. The results showed that melatonin had a significant effect on aspartate aminoteransferase (AST) (WMD = 2.29, [95 %CI: 1.14, 3.43] IU/L, p = <0.001), alkaline phosphatase (ALP) (WMD = −8.40, [95 %CI −11.33, −5.48] IU/L, p < 0.001), and gamma-glutamyltransferase (GGT) (WMD = −33.37, [95 %CI: −37.24, −29.49] IU/L, p= < 0.001). Melatonin had no significant effect on alanine aminotransferase (ALT) regarding the overall effect size. Based on this meta-analysis, melatonin supplementation can improve liver indices. However, more RCTs are required with larger sample sizes and better control of confounding variables such as weight, body mass index, and gender to determine the effect of melatonin on patients with non-alcoholic fatty acid disease.