摘要:目的：探討成都地區體檢人群中丙氨酸氨基轉移酶（ALT）升高率與其升高的相關因素,為正確分析引起ALT升高的原因提供相關依據。方法:以參與體檢的8734名體檢人群為研究對象,收集身高、體重、血壓、丙氨酸氨基轉移酶、空腹血糖、高密度脂蛋白、低密度脂蛋白、總膽固醇、甘油三酯、血清HBsAg、脂肪肝及膽石癥等相關資料進行分析。結果:在全部體檢人群中,ALT升高率為1011%,男性ALT升高率為13.70%,女性ALT升高率為6.30%,男性明顯高于女性（Plt;0001）；ALT升高組的年齡均數小于ALT正常組（Plt;0001）；在ALT升高的受檢者中,脂肪肝、高脂血癥、肥胖、糖尿病、膽囊結石、飲酒及乙肝等患病率均高于ALT正常組受檢者（Plt;005）。結論:脂肪肝、糖脂代謝紊亂及乙肝是體檢人員ALT升高的主要原因；男性和低齡也是體檢者ALT升高的危險因素。Abstract: Objective: To investigate the prevalence and relative factors of elevated serum alanine aminotransferase(ALT) levels and providescientific bases for its causes analysis in physical examination people in Chengdu. Methods: Subjects who received medical examination in physical examination center of west China hospital were screened in this study. The information of height, body weight, blood pressure, serum ALT, fasting plasma glucose, highdensity lipoprotein cholesterol, lowdensity lipoprotein cholesterol, total cholesterol, triglyceride, hepatitis B surface antigen (HBsAg) statue, fatty liver and cholelithiasis were collected and analyzed. 〖WT5”HZ〗Results:〖WT5”BZ〗 A total of 8734 cases were included in this study. The total prevalence of elevated ALT was observed in 1011%, including 137% in man and 63% in woman, and this difference between man and woman was statistic significant (P＜0001). The mean age of ALT elevated group was obvious lower than that of normal ALT group (P＜0001). Interesting, the occurrence rates of fatty liver, hyperlipidemia, obesity, diabetes,gallstones, drinking and positive hepatitis B surface antigen in ALT elevated group were all significant higher than that in normal ALT group (P＜005). Conclusion: Fatty liver, glyeolipid metabolism disorder, and hepatitis B were main reasons of elevated ALT. Male and young cases were both high risk of elevated ALT in this study.
Objective To systematically review the effect of intermittent fasting on non-alcoholic fatty liver disease (NAFLD). Methods The PubMed, EMbase, Web of Science, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect studies on the effect of intermittent fasting on NAFLD from inception to October 1, 2022. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. R software was then used for meta-analysis. Results A total of 7 studies were included. The results of meta-analysis showed that intermittent fasting could reduce liver fibrosis (MD=?0.93, 95%CI 1.67 to 0.19, P<0.05), the levels of glutamic oxaloacetic transaminase (MD=?8.96, 95%CI ?11.83 to ?6.10, P<0.05), glutamyl transpeptidase (MD=?7.86, 95%CI ?12.00 to ?3.73, P<0.05), and inflammatory molecules (MD=?2.03, 95%CI ?3.69 to ?0.36, P<0.05). In addition, it reduced dietary (total energy) intake (MD=?255.99, 95%CI ?333.15 to ?178.82, P<0.05), body weight (MD=?2.42, 95%CI ?3.81 to ?1.02, P<0.05), BMI (MD=?0.52, 95%CI ?0.92 to ?0.13, P<0.05) and fat mass (MD=?2.37, 95%CI ?4.17 to ?0.57, P<0.05). Conclusion Current research evidence shows that intermittent fasting can improve NAFLD and help patients lose weight. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To evaluate the value of medical imaging technology in qualitative and quantitative diagnosis of liver steatosis. Methods To describe the current status and advancement s of medical imaging technology such as sonography , CT and MRI in qualitative and quantitative diagnosis of liver steatosis , and to cont rast their advantages and shortages. Results Sonography could be used as the primary screening and evaluate measures in qualitative and quantitative diagnosis of liver steatosis , and CT was more reliable in quantitative diagnosis , MRI had significant improving with its high sensitivity and specificity. Conclusion Medical imaging technology has significant clinical value in qualitative and quantitative diagnosis of liver steatosis , especially with the help of functional MR imaging techniques such as spect roscopy and chemical shif t Gradient-Echo technic.
Objective To investigate the diagnostic value of proton magnetic resonance spectroscopy （1 H-MRS） on the quantification of hepatic steatosis at 3.0 T MR united.Methods Twenty-two patients who were candidated for liver surgery (living liver transplantation donor candidates, lobectomy or segmental resection for focal liver diseases, etc.) were enrolled in this study. 1 H-MRS was conducted with point resolved selective spectroscopy （PRESS） sequence, using SAGE software packages. The values of water peak (PW), lipid peak (PL) were measured, the area under water peak (AW) and lipid peak (AL), and then the relative lipid content of liver cells (RLC1, RLC2) was calculated. All subjects underwent surgical resection of liver shortly after MR scanning, fresh frozen specimens were obtained for Sudan Ⅲ staining, and staging was conducted.Results In all 22 patients, 7 patients without fatty liver, 11 patients with mild fatty liver, 4 patients with moderate or severe fatty liver. Intercomparison between different histopathological grades showed following findings: the values of PL, AL, RLC1 and RLC2 had statistical significance (Plt;0.05). The values of PL， AL， RLC1 and RLC2 were positively correlated with the proportion of fatty degenerative cells (PFDC), Plt;0.05, and the highest correlation factor was 0.771 (RLC1 to the PFDC).Conclusion 1 H-MRS can accurately quantify liver fat content and reflect the severity of hepatic steatosis. It has the potential to replace invasive liver biopsy.
ObjectiveTo investigate the feasibility of proton magnetic resonance spectroscopy (1H-MRS) imaging, by which to quantitatively analyze liver fat content for therapeutic evaluation of fatty liver at 3.0 T MRI. MethodsTwenty-six patients who diagnosed with fatty liver were examined with proton MRS at Siemens Trio Tim 3.0 T MRI before treatment and 3, 6 months after treatment, respectively. The water peak, fat peak, water peak area, and fat peak area were detected, and the relative lipid content 1 (RLC1) and relative lipid content 2 (RLC2)were calculated. Fatty liver index (FLI) was referred to the standard which was calculated from triglycerides (TG), gammaglutamyl-transferase (GGT), waist circumference, and body mass index. ResultsThere were significantly different differences of RLC1 and RLC2 among before treatment and 3, 6 months after treatment (Plt;0.05). Compared with before treatment, the RLC1 and RLC2 values significantly decreased on month 3 or 6 after treatment (Plt;0.05). There were positive correlation between RLC1 or RLC2 and FLI (r=0.476, Plt;0.00; r=0.475, Plt;0.001). The intraclass correlation coefficient was more than 0.75 before treatment, the repeatability was better. ConclusionsProton MRS can quantitatively measure liver fat content. It can be reliably used for dynamic monitoring the therapeutic effects for fatty liver. Proton MRS is accurate, and has a good clinical application in dynamically monitoring the progression of fatty liver and evaluating the therapeutic effects of various treatments.
