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维生素D在非酒精性脂肪性肝病中的作用:一项针对病态肥胖患者的横断面研究。

The Impact of Vitamin D in Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Patients with Morbid Obesity.

作者信息

Borges-Canha Marta, Neves João Sérgio, Mendonça Fernando, Silva Maria Manuel, Costa Cláudia, Cabral Pedro M, Guerreiro Vanessa, Lourenço Rita, Meira Patrícia, Salazar Daniela, Ferreira Maria João, Pedro Jorge, Leite Ana Rita, von-Hafe Madalena, Vale Catarina, Viana Sara, Sande Ana, Belo Sandra, Lau Eva, Freitas Paula, Carvalho Davide

机构信息

Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal.

Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

出版信息

Diabetes Metab Syndr Obes. 2021 Feb 3;14:487-495. doi: 10.2147/DMSO.S286334. eCollection 2021.

Abstract

PURPOSE

We aimed to evaluate the association between vitamin D status and hepatic function parameters and scores: Fatty Liver Index (FLI, predictor of hepatic steatosis) and BARD (BMI, AST/ALT ratio and DM, predictor of hepatic fibrosis) in patients with morbid obesity.

PATIENTS AND METHODS

Cross-sectional study including patients with morbid obesity followed in our centre between January 2010 and July 2018. Patients with missing vitamin D levels or hepatic profile parameters were excluded. We divided the population according to two cut-offs of vitamin D levels (12ng/mL and 20ng/mL).

RESULTS

The included population (n=1124) had an average age of 43.3±10.7 years and 84.3% were female. Seventy-point eight percent of the population had vitamin D levels lower than 20ng/mL and 34.8% lower than 12ng/dL. Patients with lower vitamin D levels (<12ng/mL) had higher BMI, hip and waist circumferences and higher prevalence of hypertension. Higher FLI scores [OR= 0.77 (0.07), p<0.01] and ALP levels [β= -0.03 (-0.06, -0.01), p<0.01] associated to lower vitamin D levels.

CONCLUSION

Vitamin D deficiency is associated with a higher risk of hepatic steatosis in individuals with morbid obesity. Correction of vitamin D deficiency may have a beneficial role in the management of NAFLD in patients with morbid obesity.

摘要

目的

我们旨在评估病态肥胖患者的维生素D状态与肝功能参数及评分之间的关联,这些参数及评分包括:脂肪肝指数(FLI,肝脂肪变性的预测指标)和BARD(BMI、AST/ALT比值及糖尿病,肝纤维化的预测指标)。

患者与方法

这是一项横断面研究,纳入了2010年1月至2018年7月在我们中心接受随访的病态肥胖患者。排除维生素D水平或肝功能检查参数缺失的患者。我们根据维生素D水平的两个临界值(12ng/mL和20ng/mL)对研究人群进行分组。

结果

纳入的人群(n = 1124)平均年龄为43.3±10.7岁,84.3%为女性。70.8%的人群维生素D水平低于20ng/mL,34.8%低于12ng/dL。维生素D水平较低(<12ng/mL)的患者BMI、臀围和腰围更高,高血压患病率更高。较低的维生素D水平与较高的FLI评分[OR = 0.77(0.07),p<0.01]和碱性磷酸酶(ALP)水平[β = -0.03(-0.06,-0.01),p<0.01]相关。

结论

维生素D缺乏与病态肥胖个体发生肝脂肪变性的较高风险相关。纠正维生素D缺乏可能对病态肥胖患者非酒精性脂肪性肝病(NAFLD)的管理具有有益作用。

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