血清铁蛋白和25-羟维生素D与老年非酒精性脂肪性肝病患者颈部血管斑块及心脏代谢指数的相关性

doi:10.3969/j.issn.1006-5725.2025.01.013

Abstract

Abstract:

Objective To investigate the correlation between serum ferritin （SF） and 25-hydroxyvitamin D ［25-（OH）D］ and cervical vascular plaque and cardiac metabolism index （CMI） in elderly patients with nonalcoholic fatty liver disease （NAFLD）. Methods 128 elderly patients with NAFLD in the hospital were selected as study group， and 80 healthy subjects with physical examination were included in control group. The levels of SF and 25-（OH）D were compared between study group and control group and among patients with different lesion degrees. According to the presence or absence of formation of carotid artery plaque， the patients were classified into plaque group （n = 36） and non-plaque group （n = 92）， and the clinical data， SF， 25-（OH）D and CMI were compared. The multiple factors affecting the cervical vascular plaque formation in elderly patients with NAFLD and the correlation of SF and 25-（OH）D levels with cervical vascular plaque and CMI were analyzed. Results Serum SF in study group was significantly higher than that in control group （P < 0.05） while 25-（OH）D level was significantly lower than that in control group （P < 0.05）. SF level was manifested as fatty liver group < steatohepatitis group < liver cirrhosis group （P < 0.05） while 25-（OH）D level revealed fatty liver group > steatohepatitis group > liver cirrhosis group （P < 0.05）. The BMI， diabetes mellitus， hyperlipidemia， serum ALT， AST， LDL-C， SF， FPG， FINS， HOMA-IR， CMI and NFS in plaque group were significantly higher than those in non-plaque group （P < 0.05） while serum 25-（OH）D level was significantly lower than that in non-plaque group （P < 0.05）. Multivariate Logistic regression analysis showed that increased BMI， serum LDL-C， SF， CMI and NFS were risk factors for carotid artery plaque formation in elderly patients with NAFLD （P < 0.05）， and serum 25-（OH）D level was a protective factor （P < 0.05）. Correlation analysis showed that SF was positively correlated with carotid artery plaque and CMI in NAFLD patients （P < 0.05）， and serum 25-（OH）D level was negatively correlated with carotid artery plaque and CMI （P < 0.05）. Conclusion Serum SF and 25-（OH）D are related to the progression of NAFLD， and may affect the cervical vascular plaque formation and cardiac metabolism. Serum SF and 25-（OH）D can be used as observation indicators for the diagnosis and treatment of vascular lesions in patients with NAFLD.

Key words: ferritin, 25-hydroxyvitamin D, nonalcoholic fatty liver disease, cervical vascular plaque, cardiac metabolism index, correlation

CLC Number:

R575.5

Lei LEI,Yun HU,Di ZHANG,Xinyu HUANG,Yu PENG. Correlation of serum ferritin and 25⁃hydroxyvitamin D with cervical vascular plaque and cardiac metabolism index in elderly patients with nonalcoholic fatty liver disease[J]. The Journal of Practical Medicine, 2025, 41(1): 78-83.

Figures/Tables 6

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References 27

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组别	例数	SF/（ng/mL）	25-(OH)D/（μg/L）
研究组	128	314.68 ± 53.46	19.66 ± 3.47
对照组	80	176.33 ± 33.79	27.16 ± 3.22
t值		20.697	15.586
P值		< 0.001	< 0.001

组别	例数	SF/（ng/mL）	25-（OH）D/（μg/L）
脂肪肝组	52	277.60 ± 43.57	23.73 ± 3.07
脂肪性肝炎组	41	316.34 ± 52.58^?	18.87 ± 3.56^?
肝硬化组	35	367.82 ± 46.29^?#	14.54 ± 3.03^?#
F值		38.011	86.769
P值		< 0.001	< 0.001

一般资料	斑块组（n = 36）	非斑块组（n = 92）	χ²/t值	P值
性别/［例（%）］
男	21（58.33）	41（44.57）	1.964	0.161
女	15（41.67）	51（55.43）	1.964	0.161
年龄/岁	70.56 ± 5.31	68.83 ± 4.42	1.879	0.063
BMI/（kg/m²）	26.74 ± 2.02	25.26 ± 2.23	3.463	0.001
吸烟史/［例（%）］	13（36.11）	22（23.91）	1.937	0.164
合并症/［例（%）］
高血压	11（30.56）	26（28.26）	0.066	0.797
糖尿病	22（61.11）	34（36.96）	6.135	0.013
高血脂	20（55.56）	30（32.61）	5.723	0.017
ALT/（U/L）	42.16 ± 7.33	38.47 ± 7.72	2.465	0.015
AST/（U/L）	38.66 ± 6.53	34.87 ± 6.23	3.053	0.003
ALP/（U/L）	86.43 ± 9.89	84.22 ± 10.37	1.098	0.274
TBIL/（μmol/L）	14.36 ± 4.13	13.22 ± 3.86	1.473	0.143
TG/（mmol/L）	1.72 ± 0.46	1.56 ± 0.44	1.826	0.070
TC/（mmol/L）	5.11 ± 1.22	4.86 ± 1.04	1.164	0.247
HDL-C/（mmol/L）	1.16 ± 0.27	1.22 ± 0.23	1.262	0.209
LDL-C/（mmol/L）	3.62 ± 1.06	3.07 ± 0.87	3.019	0.003
FBG/（mmol/L）	5.88 ± 1.32	5.15 ± 1.25	2.927	0.004
FINS/（μIU/mL）	23.44 ± 4.63	21.17 ± 4.33	2.615	0.010
HOMA-IR	5.56 ± 1.53	4.83 ± 1.38	2.609	0.010
SF/（ng/mL）	352.56 ± 45.78	299.86 ± 50.37	5.455	< 0.001
25-（OH）D/（μg/L）	16.87 ± 3.04	20.75 ± 3.22	6.224	< 0.001
CMI	1.24 ± 0.33	0.86 ± 0.27	6.713	< 0.001
NFS/分	0.72 ± 0.16	0.51 ± 0.14	7.325	< 0.001

变量	β值	S.E	Wald χ ² 值	OR值	P值	95%CI
BMI	0.775	0.285	7.395	2.171	0.007	1.242 ~ 3.795
LDL-C	0.834	0.297	7.885	2.303	0.005	1.286 ~ 4.121
SF	1.017	0.311	10.694	2.765	0.001	2.765 ~ 5.086
25-（OH）D	-1.122	0.342	10.763	0.326	0.001	0.167 ~ 0.637
CMI	1.367	0.370	13.288	3.924	< 0.001	1.881 ~ 8.183
NFS	1.384	0.358	14.945	3.991	< 0.001	1.978 ~ 8.050

指标	SF		25-（OH）D
指标	r值	P值	r值	P值
颈动脉内膜中层厚度	0.664	< 0.001	-0.731	< 0.001
CMI	0.603	< 0.001	-0.701	< 0.001

Correlation of serum ferritin and 25⁃hydroxyvitamin D with cervical vascular plaque and cardiac metabolism index in elderly patients with nonalcoholic fatty liver disease

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