Dai Yining, Zhu Jinzhou, Meng Di, Yu Chaohui, Li Youming
Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang, China.
Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
J Clin Biochem Nutr. 2016 Jan;58(1):76-83. doi: 10.3164/jcbn.15-54. Epub 2015 Aug 29.
Previous studies have reported inconsistent findings regarding the association between plasmatic higher of homocysteine level and non-alcoholic fatty liver disease. We aimed to investigate this association by conducting a meta-analysis. Literature was searched on PubMed from inception to January 2015. Eight studies evaluating plasma level of homocysteine in biopsy-proven non-alcoholic fatty liver disease subjects compared to healthy controls were included. Compared with the controls, non-alcoholic fatty liver disease patients witnessed a higher level of homocysteine [standard mean difference (SMD): 0.66 µmol/L, 95% CI: 0.41, 0.92 µmol/L], and were associated with a significant increased risk for hyperhomocysteinemia [odds ratio (OR) 5.09, 95% CI: 1.69, 15.32]. In addition, patients with non-alcoholic fatty liver presented 0.45 µmol/L higher levels of homocysteine compared to healthy controls (95% CI: 0.09, 0.82 µmol/L), whereas non-alcoholic steatohepatitis patients had 1.02 µmol/L higher levels of homocysteine (95% CI: 0.28, 1.76 µmol/L). There was neither difference of folate level nor vitamin B12 level between non-alcoholic fatty liver disease subjects and healthy controls. This study revealed that non-alcoholic fatty liver disease patients presented an increased serum concentration of homocysteine, and were associated with an increased risk of hyperhomocysteinemia. Further studies are needed to demonstrate a causal role of hyperhomocysteinemia in non-alcoholic fatty liver disease.
以往的研究报告了血浆同型半胱氨酸水平升高与非酒精性脂肪性肝病之间的关联，但结果并不一致。我们旨在通过进行一项荟萃分析来研究这种关联。在PubMed上检索了从创刊至2015年1月的文献。纳入了八项研究，这些研究评估了经活检证实的非酒精性脂肪性肝病患者与健康对照者的血浆同型半胱氨酸水平。与对照组相比，非酒精性脂肪性肝病患者的同型半胱氨酸水平更高[标准均数差（SMD）：0.66 μmol/L，95%可信区间（CI）：0.41，0.92 μmol/L]，并且与高同型半胱氨酸血症的风险显著增加相关[比值比（OR）5.09，95%CI：1.69，15.32]。此外，与健康对照者相比，非酒精性脂肪性肝病患者的同型半胱氨酸水平高0.45 μmol/L（95%CI：0.09，0.82 μmol/L），而非酒精性脂肪性肝炎患者的同型半胱氨酸水平高1.02 μmol/L（95%CI：0.28，1.76 μmol/L）。非酒精性脂肪性肝病患者与健康对照者之间的叶酸水平和维生素B12水平均无差异。这项研究表明，非酒精性脂肪性肝病患者的血清同型半胱氨酸浓度升高，并且与高同型半胱氨酸血症的风险增加相关。需要进一步的研究来证明高同型半胱氨酸血症在非酒精性脂肪性肝病中的因果作用。
