血管紧张素转换酶水平与老年非酒精性脂肪肝发病的关系

摘要

目的：探讨老年患者非酒精性脂肪肝( nonalcoholic fatty liver disease,NAFLD)的血管紧张素转换酶( angiotensin converting enzyme,ACE)循环水平,并分析其与老年NAFLD发病的相关性。方法入选205例河北省张家口蔚县人民医院老年人群(年龄>60岁),经临床诊断及肝脏B超检查分为NAFLD组与对照组,检测其ACE、肝功能、血脂、血糖等生化指标,并行统计分析。结果 NAFLD组较对照组ACE、谷丙转氨酶(alanine transaminase,ALT)、碱性磷酸酶(alkaline phosphatase,ALP)、甘油三酯(triglycerides,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein,LDL-C)显著升高(P<0.05),而高密度脂蛋白胆固醇(high-density lipoprotein,HDL-C)则显著降低(P=0.000)；ACE、ALT、TG为NAFLD的独立危险因素(OR分别为1.035、1.059、2.475,P<0.05)；ACE分别与ALP、TG、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白( glycosylated hemoglobin A1c, HbA1c )呈正相关( r 分别为0.275、0.270、0.186、0.188, P<0.05)。结论 ACE在老年NAFLD患者中显著升高,且是老年NAFLD发病机制的主要因素。%Objective To investigate the concentration of angiotensin converting enzyme ( ACE) in nonalcoholic fatty liver disease ( NAFLD) of the elderly, and the correlation between ACE and the elderly NAFLD patients. Method 205 elderly ( age>60 years) hospitalized patients and outpatients were divided into two groups:the elderly NAFLD group and the control group, who were diagnosed by the abdominal ultrasound and clinical diagnosis. All patients’ plasma ACE was measured, as well as the indexes of transaminase, blood lipids, fasting blood glucose, et al. The indexes were analyzed by SPSS 13. 0. Result The concentration of plasma ACE, ALT, ALP, TG, TC, LDL-C of the elderly NAFLD group were higher than those of the control group(P<0. 05). But the concentration of HDL-C of the NAFLD group was lower than that of the control group. ACE, ALT and TG were respectively independent risk factors. (OR=1. 035;1. 059;2. 475, P<0. 05). ACE was positively correlated with ALP, TG, FBG, HbA1c ( r=0. 275;0. 270;0. 186;0. 188,P<0. 05). Conclusion The concentration of plasma ACE in the elderly NAFLD pa-tients is increasing. The rise of ACE closely relates with the elderly NAFLD patients, which has a key effect on the occurrence of NAFLD.