不同血清叶酸形式与非酒精性脂肪性肝病和肝纤维化指标的相关性。
Associations of different serum folate forms with indices of nonalcoholic fatty liver disease and advanced fibrosis.
机构信息
Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China.
Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou 510515, China; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China; Institute of Biomedicine, Anhui Medical University, Hefei 230032, China.
出版信息
Obes Res Clin Pract. 2023 Jan-Feb;17(1):58-65. doi: 10.1016/j.orcp.2023.01.004. Epub 2023 Feb 4.
OBJECTIVE
We aim to examine the associations of different serum folate forms (total folate, 5-methyltetrahydrofolate [5-mTHF] and unmetabolized folic acid [UMFA]), with the prevalence of nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis.
METHODS
This cross-sectional analysis was conducted in 6610 participants aged ≥ 18 years from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) database. NAFLD was defined as a United States fatty liver index (USFLI) ≥ 30. Advanced fibrosis was defined as a Fibrosis-4 score (FIB-4) > 3.25, a NAFLD Fibrosis Score (NFS) > 0.676, and a Hepamet Fibrosis Score (HFS) ≥ 0.47, respectively.
RESULTS
The prevalence of NAFLD was 34.5%. Overall, serum total folate and 5-mTHF were inversely associated with the prevalence of NAFLD (both P for trend across quartiles <0.001). A similar trend was found for advanced fibrosis based on NFS and HFS (both P for trend across quartiles <0.05). However, a higher concentration of UMFA was significantly related to a higher prevalence of NAFLD (P for trend across quartiles =0.004). A similar relation was found for advanced fibrosis based on NFS (P for trend across quartiles =0.024).
CONCLUSIONS
Higher concentrations of serum total folate and 5-mTHF were associated with a lower prevalence of NAFLD and advanced fibrosis, while a higher concentration of UMFA was related to a higher prevalence of NAFLD.
目的
本研究旨在探讨不同血清叶酸形式（总叶酸、5-甲基四氢叶酸[5-mTHF]和未代谢叶酸[UMFA]）与非酒精性脂肪性肝病（NAFLD）和肝纤维化程度的相关性。
方法
本横断面研究纳入了 2011-2018 年国家健康和营养调查（NHANES）数据库中≥18 岁的 6610 名参与者。NAFLD 定义为美国脂肪肝指数（USFLI）≥30。肝纤维化程度定义为 Fibrosis-4 评分（FIB-4）>3.25、NAFLD 纤维化评分（NFS）>0.676 和 Hepamet 纤维化评分（HFS）≥0.47。
结果
NAFLD 的患病率为 34.5%。总体而言，血清总叶酸和 5-mTHF 与 NAFLD 的患病率呈负相关（趋势 P 值均<0.001）。根据 NFS 和 HFS，肝纤维化程度也存在类似的趋势（趋势 P 值均<0.05）。然而，UMFA 浓度较高与 NAFLD 的高患病率显著相关（趋势 P 值均=0.004）。根据 NFS，肝纤维化程度也存在类似的关系（趋势 P 值=0.024）。
结论
血清总叶酸和 5-mTHF 浓度较高与 NAFLD 和肝纤维化程度较低相关，而 UMFA 浓度较高与 NAFLD 患病率较高相关。
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