非酒精性脂肪性肝病患者血清载脂蛋白B水平及其临床意义探讨*

doi:10.3969/j.issn.1672-5069.2019.01.017

摘要/Abstract

摘要： 目的研究非酒精性脂肪性肝病（NAFLD）患者血清载脂蛋白B（ApoB）水平变化及其临床意义。方法 2015年2月~2017年11月在我院体检人群1451例,经超声和 FibroTouch检查诊断NAFLD,采用免疫比浊法测定血清ApoB水平。结果在1451例体检人群中,发现NAFLD患者360例（24.8%）;NAFLD组血清ApoB水平为（1.07±0.24） g/L,显著高于1091例对照组【（0.88±0.27） g/L,P<0.01】;把血清ApoB水平分为263例Q1（<0.73 g/L）、364例Q2（0.73~0.85 g/L）、321例Q3（0.86~0.99 g/L）、300例Q4（1.0~1.16 g/L）和203例Q5（≥1.17 g/L）组,其NAFLD检出率分别为4.2%、9.9%、19.0%、25.0%和34.5%,显示随着血清ApoB水平的升高,NAFLD患病率也显著上升（P<0.05）;同样,随着血清ApoB水平升高,代谢综合征各临床表型发生率也显著升高;多因素Logistic回归分析结果显示,性别、舒张压、体质指数、血清TC、HDL、FPG和ApoB是发生NAFLD的危险因素。结论血清ApoB水平升高是发生NAFLD的危险因素,发现血清ApoB水平升高者,应及时行相关检查以明确NAFLD的存在,对于临床上早期干预可能具有重要的意义。

关键词: 非酒精性脂肪性肝病, 载脂蛋白B类, 血脂, 代谢综合征

Abstract: Objectives To investigate the implication of serum apolipoprotein B（ApoB） levels and its correlation with metabolic syndrome（MS） in checked-up individuals. Methods The physical examination was carried out in 1451 individuals between February 2015 and November 2017 in our hospital,and they were screened for nonalcoholic fatty liver disease （NAFLD） by ultrasonography and FibroTouch. Serum ApoB level was assayed routinely. The influencing factors of NAFLD occurrence was analyzed by Logistic regression analysis. Results Out of the 1451 individuals,the incidence of NAFLD was 24.8%;serum ApoB level in 360 patients with NAFLD was（1.07±0.24）g/L,significantly higher than【（0.88±0.27） g/L,P<0.01】 in 1091 individuals without NAFLD;serum ApoB levels were divided into Q1（<0.73 g/L） in 263,Q2（0.73~0.85 g/L） in 364,Q3（0.86~0.99 g/L） in 321,Q4（1.0~1.16 g/L） in 300 and Q5（≥1.17 g/L） in 203 persons,and their morbidity of NAFLD were 4.2%,9.9%,19.0%,25.0% and 34.5%,suggesting higher incidence rate of NAFLD in those with higher serum ApoB levels（P<0.05）;in the same way,the incidence rates of various clinical types of MS,such as visceral obesity,hypertension,hypertriglyceridemia and hyperglycemia,increased as serum ApoB levels increased;multivariate Logistic regression analysis showed that gender,diastolic blood pressure,body mass index,blood lipids,fasting blood glucose and serum ApoB levels were the independent risk factors for NAFLD occurrence. Conclusion Elevated serum ApoB level might hint the existence of NAFLD,which warrants further check-up in clinical practice.

Key words: Non-alcoholic fatty liver disease, Apolipoprotein B, Blood lipids, Metabolic syndrome

张枫, 阎妍. 非酒精性脂肪性肝病患者血清载脂蛋白B水平及其临床意义探讨^*[J]. 实用肝脏病杂志, 2019, 22(1): 61-64.

Zhang Feng, Yan Yan.. Implication of serum apolipoprotein B levels and its correlation with metabolic syndrome in checked-up individuals[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(1): 61-64.

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非酒精性脂肪性肝病患者血清载脂蛋白B水平及其临床意义探讨^*

Implication of serum apolipoprotein B levels and its correlation with metabolic syndrome in checked-up individuals

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