Endoscopic Diagnosis and Treatment Center, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
Department of Colorectal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Scand J Gastroenterol. 2022 Jul;57(7):872-877. doi: 10.1080/00365521.2022.2041085. Epub 2022 Feb 21.
This study aimed to investigate the association between serum vitamin C and liver fibrosis in patients with NAFLD in the US adults.
We conducted a cross-sectional analysis of data from the 2017 to 2018 cycle of National Health and Nutrition Examination Survey (NHANES). Serum vitamin C and transient elastography (TE)-accessed liver stiffness was taken as independent and dependent variables, respectively. Liver steatosis and fibrosis were detected by controlling attenuation parameter (CAP) and TE. NAFLD was defined by a CAP score of ≥248 dB/m without any indication of other causes of chronic liver disease. The median liver stiffness of ≥8.2 kPa was used to identify significant fibrosis (≥F2) among NAFLD patients. We calculated the adjusted odds ratio (OR) and 95% confidential intervals (CIs) for associations with significant NAFLD fibrosis using multivariable logistic regression models.
Overall, 1926 individuals with NAFLD were included in the analysis and 267 subjects met the definition of significant fibrosis. Serum vitamin C was associated with lower odds of liver fibrosis in NAFLD after adjusting for potential confounders (OR = 0.60, 95% CI, 0.43-0.84), while in the subgroup analysis stratified by gender and body mass index (BMI), this association showed a difference after adjusting for confounders (males: OR = 0.43, 95% CI, 0.26-0.71; females: OR = 0.78, 95% CI, 0.49-1.24). There were no significant associations of serum vitamin C with liver fibrosis in NAFLD with underweight or normal (OR = 1.34, 95% CI, 0.19-9.34).
This cross-sectional study indicated an association of serum vitamin C with significant fibrosis in men and overweight or obese patients with NAFLD.
本研究旨在探讨美国成年人非酒精性脂肪性肝病（NAFLD）患者血清维生素 C 与肝纤维化之间的关系。
我们对 2017 年至 2018 年国家健康和营养检查调查（NHANES）的横断面数据分析。血清维生素 C 和瞬时弹性成像（TE）评估的肝硬度分别作为独立和依赖变量。通过控制衰减参数（CAP）和 TE 检测肝脂肪变性和纤维化。NAFLD 的定义为 CAP 评分≥248dB/m 且无任何其他慢性肝病原因的指标。中位肝硬度≥8.2kPa 用于识别 NAFLD 患者的显著纤维化（≥F2）。我们使用多变量逻辑回归模型计算了与显著 NAFLD 纤维化相关的调整比值比（OR）和 95%置信区间（CI）。
总体而言，纳入分析的 1926 名 NAFLD 患者中有 267 名符合显著纤维化的定义。在校正潜在混杂因素后，血清维生素 C 与 NAFLD 肝纤维化的发生几率呈负相关（OR=0.60，95%CI，0.43-0.84），但在按性别和体重指数（BMI）分层的亚组分析中，在校正混杂因素后，这种相关性存在差异（男性：OR=0.43，95%CI，0.26-0.71；女性：OR=0.78，95%CI，0.49-1.24）。血清维生素 C 与 NAFLD 肝纤维化的相关性在体重不足或正常的患者中不显著（OR=1.34，95%CI，0.19-9.34）。
这项横断面研究表明，血清维生素 C 与男性和超重或肥胖的 NAFLD 患者的显著纤维化有关。
