目的 探究老年非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)患者血清25-羟维生素D3[25(OH)D3]水平的变化及与胰岛素抵抗、氧化应激之间的关系。方法 选取2018-01至2020-04在我院诊治的125例老年NAFLD患者作为观察组,按血清25(OH)D3水平分为维生素D缺乏组、维生素D不足组和维生素D正常组三个亚组;另选取同期老年健康体检者30例作为对照组。比较观察组与对照组血清25(OH)D3水平差异;对比观察组三个亚组体质量(BMI)、血脂、肝功能、空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)等各指标差异;分析观察组血清25(OH)D3水平与以上指标的相关性。结果 与对照组相比,观察组25(OH)D3、SOD、GSH-Px水平显著下降,BMI、FINS、HOMA-IR、MDA水平显著升高(P<0.05)。与维生素D正常组相比,维生素D缺乏组和维生素D不足组FINS、HOMA-IR、MDA水平显著升高,SOD、GSH-Px水平显著降低(P<0.05);其中维生素D缺乏组各指标水平高于或低于维生素D不足组(P<0.05)。观察组25(OH)D3水平与HOMA-IR、MDA呈显著负相关(r=-0.395,r=-0.328,P均<0.05);与SOD、GSH-Px呈显著正相关(r=0.388,r=0.376,P均<0.05)。结论 老年NAFLD患者血清25(OH)D3水平明显下降,血清25(OH)D3缺乏与胰岛素抵抗及氧化应激密切相关。
Abstract
Objective To investigate the changes of serum 25-hydroxyvitamin D3 (25(OH)D3) levels in elderly patients with non-alcoholic fatty liver disease (NAFLD) and the relationship between them and insulin resistance and oxidative stress.Methods A total of 125 elderly NAFLD patients treated in our hospital from January 2018 to April 2020 were selected as the observation group and divided into three subgroups according to serum 25(OH)D3 levels: vitamin D deficiency group, vitamin D insufficiency group and vitamin D normal group;Another 30 elderly healthy subjects were selected as the control group. The serum 25(OH)D3 level was compared between the observation group and the control group.The differences of body mass index (BMI), blood lipid, liver function, fasting blood glucose (FBG), fasting insulin (FINS), insulin resistance index (HOMA-IR), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) between three subgroups of the observation group were compared. The correlation between serum 25(OH)D3 level and the above indexes in observation group was analyzed.Results Compared with the control group, the levels of 25 (OH) D3, SOD and GSH-Px in the observation group were significantly decreased, and the levels of BMI, FINS, HOMA-IR and MDA were significantly increased (P<0.05). Compared with vitamin D normal group, the levels of FINS, HOMA-IR and MDA in vitamin D deficiency group and vitamin D insufficiency group were significantly increased, while the levels of SOD and GSH-Px were significantly decreased (P<0.05); The levels of each index in vitamin D deficiency group were higher or lower than those in vitamin D insufficiency group (P<0.05). 25 (OH) D3 level was significantly negatively correlated with HOMA-IR and MDA (r=-0.395, r=-0.328, all P<0.05), and positively correlated with SOD and GSH-Px In the observation group (r=0.388, r=0.376, all P<0.05).Conclusions The level of serum 25(OH)D3 in elderly patients with NAFLD decreased significantly, and the deficiency of serum 25(OH)D3 was closely related to insulin resistance and oxidative stress.
关键词
非酒精性脂肪肝 /
25-羟维生素D3 /
胰岛素抵抗 /
氧化应激
Key words
non-alcoholic fatty liver disease /
25 hydroxyvitamin D3 /
insulin resistance /
oxidative stress
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参考文献
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基金
国家老年疾病临床医学研究中心开放课题(2019023)
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