天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (12): 1316-1318.doi: 10.11958/20180847

• 临床研究 • 上一篇    下一篇

维生素D对非酒精性脂肪性肝病患者铁代谢的影响

刘志平，张金华，王湘宁，徐莹   

  1. 武汉市汉口医院消化内科（邮编430012）
  • 收稿日期:2018-05-30 修回日期:2018-08-10 出版日期:2018-12-15 发布日期:2019-01-24
  • 通讯作者: 刘志平 E-mail:xiao6599@sina.com

Effect of vitamin D on serum markers of iron metabolism in patients with non-alcoholic fatty liver disease

LIU Zhi-ping,ZHANG Jin-hua,WANG Xiang-ning,XU Ying   

  1. Department of Gastroenterology, Hankou Hospital, Wuhan 430012, China
  • Received:2018-05-30 Revised:2018-08-10 Published:2018-12-15 Online:2019-01-24

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摘要： 目的 探讨非酒精性脂肪性肝病（NAFLD）患者血清维生素D水平对血清铁（SI）、铁蛋白（SF）及铁调素（Hepc）的影响及意义。方法 单纯性NAFLD患者186例根据血清25羟维生素D［3 25（OH）D3］水平分为维生素D缺乏组［25（OH）D3≤20 μg/L，115例，］和非缺乏组（71例），比较2组患者年龄、性别、体质指数（BMI）、血压、血脂、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶（GGT）、空腹血糖（FPG）、空腹胰岛素（FINS）、稳态模型胰岛素抵抗指数（HOMA-IR）、SI、SF及Hepc水平；分析25（OH）D3与SI、SF、Hepc及HOMA-IR之间的相关性。结果 2组患者SI差异无统计学意义（P＞0.05），维生素D缺乏组BMI、FINS、SF、Hepc水平及HOMA-IR均高于非缺乏组（P＜0.05）。血清 25（OH）D3水平与 SF（r=-0.328）、Hepc（r=-0.314）及 HOMA-IR（r=-0.293）呈弱负相关（P＜ 0.05）。结论 维生素D水平下降增加了NAFDL患者体内铁负荷，加重了胰岛素抵抗。

关键词: 维生素D, 骨化二醇, 铁代谢障碍, 铁调素, 铁蛋白, 非酒精性脂肪性肝病, 胰岛素抵抗

Abstract: Objective To investigate the effects of vitamin D on serum iron (SI), ferritin(SF) and hepcidin (Hepc) in patients with nonalcoholic fatty liver disease (NAFLD). Methods There were 186 patients with NAFLD in this study. All these patients were divided into two groups according to the level of serum 25-hydroxyvitamin D3 [25(OH)D3)], deficient group (25(OH)D3≤20 μg/L, n=115) and non-deficient group (n=71). The age, gender, body mass index (BMI), blood pressure,serum lipids, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment for insulin resistance (HOMA-IR), SI, SF and Hepc were compared between the two groups. The correlations between 25(OH)D3 and serum markers of iron metabolism were analyzed. Results There was no significant difference in SI between the two groups (P＞0.05). The levels of BMI,FINS, SF, Hepc and HOMA-IR were significantly higher in deficient group than those of non-deficient group (P＜0.05). The pearson correlational analysis showed that 25(OH)D3 was negative related to SF (r=-0.328), Hepc (r=-0.314) and HOMA-IR (r=- 0.293, P＜0.05). Conclusion The deficiency of vitamin D causes iron overload in patients with NAFLD, and aggravates insulin resistance.

Key words: vitamin D, calcifediol, iron metabolism disorders, hepcidin, serum ferritin, nonalcoholic fatty liver disease, insulin resistance