合肥市成年男性血清25(OH)D<sub>3</sub>水平与酒精性脂肪肝病的相关性

王晓宇; 王惠惠; 曾藜; 龚渭轶; 杨冰冰; 徐德祥; 胡纯秋

doi:10.16462/j.cnki.zhjbkz.2023.08.010

合肥市成年男性血清25(OH)D₃水平与酒精性脂肪肝病的相关性

doi: 10.16462/j.cnki.zhjbkz.2023.08.010

1.
安徽医科大学公共卫生学院营养与食品卫生学系，合肥 230032
2.
安徽医科大学第四附属医院消化内科，合肥 230032
3.
安徽医科大学公共卫生学院卫生毒理学系，合肥 230032

基金项目:

国家自然科学基金 81402676

安徽省高等学校科学研究项目 2022AH040094

详细信息

通讯作者:
HU Chunqiu, E-mail: huchqiu@163.com

中图分类号: R181;R589
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- 被引次数: 0
出版历程
- 收稿日期: 2022-11-08
- 修回日期: 2023-01-15
- 网络出版日期: 2023-09-02
- 刊出日期: 2023-08-10

Correlation between serum 25(OH)D₃ levels and alcoholic fatty liver disease in adult males in Hefei

1.
School of Public Health, Department of Nutrition and Food Hygiene, Anhui Medical University, Hefei 230032, China
2.
Gastroenterology Department of the Fourth Hospital of Anhui Medical University, Hefei 230032, China
3.
School of Public Health, Department of Health Toxicology, Anhui Medical University, Hefei 230032, China

Funds:

National Natural Science Foundation of China 81402676

Natural Research Project of Higher Education of Anhui Provence 2022AH040094

摘要

摘要: 目的探讨合肥市成年男性血清25-羟维生素D₃[25-hydroxy vitamin D₃, 25(OH)D₃]水平与酒精性脂肪肝病(alcohol fatty liver disease，AFLD)的相关性。方法按入选标准收集AFLD患者90例及健康对照90例。通过问卷收集研究对象一般情况，查阅电子病历并收集临床检查资料，采用放射免疫分析法检测血清25(OH)D₃水平，logistic回归模型分析血清25(OH)D₃水平与AFLD的相关性。结果 Mann-Whitney U检验显示AFLD患者血清25(OH)D₃水平[49.15(39.08, 71.09)]低于对照组[67.04(51.03, 76.84)](Z=-4.088, P＜0.001)。趋势性χ²检验显示AFLD患病率随25(OH)D₃水平增加而降低(χ² _趋势=13.13，P＜0.001)。Mann-Whitney U检验显示中重度AFLD组25(OH)D₃水平[38.46(30.22，42.41)]低于轻度AFLD组[52.70(42.41，73.13)]，且差异有统计学意义(Z=-3.172, P=0.001)。Logistic回归分析模型显示在调整混杂因素后，相对于血清25(OH)D₃缺乏的男性，血清25(OH)D₃不足和充足男性的AFLD发生风险降低(OR=0.085、OR=0.827)。结论血清25(OH)D₃水平与AFLD发生风险及严重程度有关。
- 25(OH)D₃水平 /
- 酒精性脂肪肝病 /
- 成年男性 /
- 相关性
Abstract: Objective To explore the correlation between 25-hydroxy vitamin D₃ [25(OH)D₃] level and alcoholic fatty liver disease (AFLD) of adult males in Hefei. Methods A total of 90 patients with AFLD and 90 healthy controls were collected according to the inclusion criteria. General information of study subjects were collected through questionnaires, electronic medical records were consulted and clinical examination data were collected. Serum 25(OH)D₃ levels were detected by radioimmunoassay. The correlation between serum 25(OH)D₃ levels and AFLD was analyzed by logistic regression model. Results Mann-Whitney U test showed that serum 25(OH)D₃ [49.15(39.08, 71.09)] in patients with AFLD were significantly lower than the control group [67.04(51.03, 76.84)] (Z=-4.088, P < 0.001). Trending χ² test showed that the prevalence of AFLD increases with increasing 25(OH)D₃ levels (χ² _trend=13.13, P < 0.001). Mann-Whitney U test showed that the level of 25(OH)D₃ [38.46(30.22, 42.41)] in the moderate to severe AFLD group was significantly lower than that in the mild AFLD group [52.70(42.41, 73.13)], and the difference was statistically significant (Z=-3.172, P=0.001). The logistic regression analysis showed that men with insufficient and adequate serum 25(OH)D₃ had a reduced risk of AFLD when compared with men with serum 25(OH)D₃ deficiency after adjusting for confounders (OR=0.085, OR=0.827). Conclusion The serum 25(OH)D₃ level of adult men in Hefei was associated with the risk and severity of AFLD.
- 25(OH)D₃ level /
- Alcoholic fatty liver disease /
- Adult males /
- Relevance

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图 1 轻度AFLD组与中重度AFLD组的25(OH)D₃水平比较

AFLD: 酒精性脂肪肝病；25(OH)D₃: 25-羟维生素D₃。

Figure 1. Comparison of 25(OH)D₃ levels between mild and moderate to severe AFLD groups

AFLD: alcohol fatty liver disease; 25(OH)D₃: 25-hydroxy vitamin D₃.

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表 1 研究对象一般特征和临床检测资料比较

Table 1. Comparison of basic characteristics and clinical examination data of study participants

特征Characteristic	AFLD ^① (n=90)	对照^① Control ^① (n=90)	t/Z/χ²值 value	P值 value
年龄/岁Age /year	52.63±8.64	52.23±8.63	-0.311	0.756
BMI/(kg·m^-2)	25.28±3.05	22.09±2.63	-5.010	＜0.001
尿酸/(μmol·L^-1) Trioxypurine /(μmol·L^-1)	364.15±54.62	315.20±61.44	-3.766	＜0.001
肌酐/(μmol·L^-1) Creatinine /(μmol·L^-1)	71.64±11.17	71.89±12.23	0.095	0.924
总胆固醇/(mmol·L^-1) Total cholesterol /(mmol·L^-1)	5.12±1.03	4.70±0.79	-1.921	0.058
低密度脂蛋白/(mmol·L^-1) Low density lipoprotein /(mmol·L^-1)	2.91±0.83	2.58±0.58	-2.084	0.040
高密度脂蛋白/(mmol·L^-1) High-density lipoprotein /(mmol·L^-1)	1.29(1.14，1.47)	1.40(1.23，1.68)	1.858	0.063
丙氨酸氨基转移酶/(U·L^-1) Alanine aminotransferase /(U·L^-1)	29(17.00，44.00)	15(12.00，19.00)	-7.683	＜0.001
天冬氨酸氨基转移酶/(U·L^-1) Aspartic transaminase /(U·L^-1)	24(21.00，32.00)	20(17.00，23.00)	-5.603	＜0.001
总胆红素/(μmol·L^-1) Total bilirubin /(μmol·L^-1)	13.95(11.55，19.20)	14.20(11.13，16.65)	0.397	0.691
空腹血糖/(mmol·L^-1) Fasting glucose /(mmol·L^-1)	6.03(5.18，7.17)	5.60(5.03，6.00)	-3.191	0.001
三酰甘油/(mmol·L^-1) Triglyceride /(mmol·L^-1)	1.51(1.02，2.17)	1.12(0.74，1.47)	-2.723	0.006
25(OH)D₃/(nmol·L^-1)	49.15(39.08，71.09)	67.04(51.03，76.84)	-4.088	＜0.001
静坐工作时间/h Sitting work time /h	9(6.00，9.00)	6.5(1.75，9.00)	-1.944	0.052
高血压Hypertension			11.168	0.001
是Yes	45(77.60)	13(22.40)
否No	45(37.00)	77(63.00)
曾经吸烟Smoking			6.765	0.009
是Yes	72(60.50)	47(39.50)
否No	18(29.00)	43(71.00)
锻炼Exercise			1.020	0.600
是Yes	34(50.00)	34(50.00)
否No	56(50.00)	56(50.00)
注：BMI, 体质指数; 25(OH)D₃，25-羟维生素D₃；AFLD，酒精性脂肪肝病。 ①以(x±s)或[M(P₂₅, P₇₅)]或[人数(占比/%)]表示。 Note: BMI, body mass index; 25(OH)D₃, 25-hydroxy vitamin D₃; AFLD, alcohol fatty liver disease. ① (x±s) or [M(P₂₅, P₇₅)] or [Number of people (proportion /%)].

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表 2 25(OH)D₃水平与AFLD的关联

Table 2. Association between 25(OH)D₃ levels and AFLD

25(OH)D₃水平 25(OH)D₃ Level/(nmol·L^-1)	病例数 Number of cases	患病率/% Prevalence rate/%	χ_趋势²值 χ_trend² value	P值 value
＜50	46	51.10	13.13	＜0.001
50~＜75	28	31.10
≥75	16	17.80
注：25(OH)D₃，25-羟维生素D₃；AFLD，酒精性脂肪肝病。 Note: 25(OH)D₃, 25-hydroxy vitamin D3; AFLD, alcohol fatty liver disease.

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表 3 25(OH)D₃与AFLD的多因素logistic回归分析模型

Table 3. Multivariate logistic regression analysis model of 25(OH)D₃ and AFLD

特征 Characteristic	β	Wald值 value	OR值 value	95% CI		P值 value
特征 Characteristic	β	Wald值 value	OR值 value	下限 Lower limit	上限 Upper limit	P值 value
25(OH)D₃/(nmol·L^-1)
缺乏Deficiency			1.000
不足Inadequateness	-2.463	4.962	0.085	0.010	0.744	0.026
充足Adequation	-0.190	4.657	0.827	0.695	0.983	0.031
曾经吸烟Smoking
否No			1.000
是Yes	1.480	3.021	4.395	0.828	23.332	0.082
高血压Hypertension
否No			1.000
是Yes	-0.633	0.055	0.531	0.003	106.29	0.815
年龄/岁Age/years	-0.099	0.870	0.906	0.735	1.115	0.351
三酰甘油/(mmol·L^-1) Triglyceride /(mmol·L^-1)	0.526	1.172	1.693	0.653	4.389	0.279
丙氨酸氨基转移酶/(U·L^-1) Alanine aminotransferase /(U·L^-1)	0.265	4.045	1.303	1.007	1.687	0.044
天冬氨酸氨基转移酶/(U·L^-1) Aspartic transaminase /(U·L^-1)	0.183	0.946	1.201	0.831	1.736	0.331
空腹血糖/(mmol·L^-1) Fasting glucose /(mmol·L^-1)	0.040	0.008	1.041	0.441	2.458	0.927
BMI/(kg·m^-2)	0.424	4.223	1.529	1.020	2.292	0.040
尿酸/(μmol·L^-1) Trioxypurine /(μmol·L^-1)	0.003	0.177	1.003	0.988	1.019	0.674
注：25(OH)D₃，25-羟维生素D₃；AFLD，酒精性脂肪肝病; BMI, 体质指数。 Note: 25(OH)D₃, 25-hydroxy vitamin D3; AFLD, alcohol fatty liver disease; BMI, body mass index.

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