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目的探讨IL-33对非酒精性脂肪性肝病(NAFLD)的预测诊断价值及其相关影响因素。方法选取2012年10月至2013年1月间在中山大学第三附属医院体检中心体检人群,将符合NAFLD诊断标准的140例患者纳入病例组;同时将明确排除NAFLD,不饮酒且无心血管疾病及其他慢性病,性别、年龄匹配的140名健康体检人群纳入对照组。分别对两组人群进行身高、体重、腰围、臀围、血压进行测量,对空腹静脉血的谷丙转氨酶(ALT)、谷草转氨酶(AST)、空腹血糖、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸和血清IL-33等指标进行检测。采用多因素非条件logistic回归分析以及ROC曲线的绘制,探索IL-33与非酒精性脂肪性肝病的关系。结果共研究NAFLD患者140例,其中男性87例,女性53例,平均年龄为(54.51±9.08)岁。对照组140人,男性76人,女性64人,平均年龄为(52.69±9.22)岁。两组平均年龄、性别构成差异均无统计学意义(均P>0.05)。NAFLD组收缩压、舒张压、体质指数(BMI)、腰围、臀围、腰臀比、ALT、TG及血尿酸均高于对照组(P<0.01);NAFLD组HDL-C胆固醇低于对照组(均P<0.01)。NAFLD组超重或肥胖、高血压、血脂异常、代谢综合征以及高尿酸血症的患病率均高于对照组,差异有统计学意义(P<0.01);NAFLD组、对照组的血清IL-33水平分别为(3.92±1.96)、(1.92±1.31)pg/mL,NAFLD组高于对照组(P<0.01)。高IL-33、高ALT、高TG、超重或肥胖、高血压是NAFLD的危险因素(OR=3.678、1.091、2.557、6.437、2.383);高HDL-C是NAFLD的保护因素(OR=0.069)。IL-33预测诊断NAFLD的曲线下面积为0.819,ALT为0.665,TG为0.749,HDL-C为0.720,BMI为0.776,均具有统计学意义(均P<0.01)。结论 IL-33作为NAFLD的独立危险因素,在NAFLD的发生发展中起着重要作用,并对其具有一定的诊断价值。
Objective To investigate the predictive value of IL-33 in non-alcoholic fatty liver disease (NAFLD) and its related factors. Methods From October 2012 to January 2013, the physical examination population of the Third Affiliated Hospital of Sun Yat-sen Medical Center was enrolled in this study. 140 patients meeting NAFLD diagnostic criteria were enrolled in the case group. NAFLD, alcohol consumption and no cardiovascular disease were also excluded Other chronic diseases, gender, age-matched 140 healthy people were included in the control group. The body weight, waist circumference, hip circumference and blood pressure of the two groups were measured. The levels of ALT, AST, fasting blood glucose, total cholesterol (TC), triglyceride TG, HDL-C, LDL-C, serum uric acid and serum IL-33 were measured. Multivariate non-conditional logistic regression analysis and ROC curve were used to explore the relationship between IL-33 and non-alcoholic fatty liver disease. Results A total of 140 NAFLD patients were studied, including 87 males and 53 females, with an average age of (54.51 ± 9.08) years. The control group of 140 people, 76 males and 64 females, the average age was (52.69 ± 9.22) years. There was no significant difference between the two groups in mean age and gender (all P> 0.05). The systolic blood pressure, diastolic blood pressure, body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, ALT, TG and serum uric acid in NAFLD group were significantly higher than those in control group (All P <0.01). The prevalence of overweight or obesity, hypertension, dyslipidemia, metabolic syndrome and hyperuricemia in NAFLD group were significantly higher than those in control group (P <0.01). In NAFLD and control groups, the levels of IL- 33 levels were (3.92 ± 1.96) and (1.92 ± 1.31) pg / mL respectively, while those in NAFLD group were higher than those in control group (P <0.01). Hypertension was the risk factor for NAFLD (OR = 3.678,1.091,2.557,6.437,2.383); high HDL-C was the protective factor of NAFLD (OR = 0.069) . The area under the curve of IL-33 predicted NAFLD was 0.819, ALT was 0.665, TG was 0.749, HDL-C was 0.720 and BMI was 0.776, both of which were statistically significant (all P <0.01). Conclusion IL-33, as an independent risk factor for NAFLD, plays an important role in the development of NAFLD and has certain diagnostic value.