Analysis Of Bile Acid Levei And Related Factors In Patients With Nonalcoholic Fatty Liver Disease

Objective: nonalcoholic fatty liver disease(NAFLD)is the most common and important chronic liver disease in the world.It is a metabolic stress liver injury related to insulin resistance(IR)and genetic susceptibility.With the prevalence of obesity and metabolic syndrome,the prevalence of non-alcoholic fatty liver disease is increasing year by year.The purpose of this study was to investigate bile acid levels and related factors in patients with nonalcoholic fatty liver disease.Methods: From March 2019 to January 2020,a total of 334 patients in the department of geriatrics and physical examination center of renji hospital affiliated to Shanghai jiao tong university were selected.Among them,169 patients without NAFLD were control group and 165 patients with NAFLD,and collect two groups of general information and relevant indicators.Liver fibrosis score(NFS)was used to divide NAFLD patients into group A(n = 111 The group with progressive fibrosis was excluded NFS<-1.455)and group B(n = 54 Medium to high risk group for fibrosis NFS >-1.455).SPSS22.0 statistical software was used for statistical processing.The general clinical data and indicators of bile acid,fasting blood glucose and high-density lipoprotein were compared between the two groups,and the risk factors associated with NAFLD liver fibrosis were analyzed by multivariate Logistic regression analysis.Results: There was no significant difference in serum TBA level between the control group and the NAFLD group(2.7(1.5,4.15)VS(2.5(1.7,4.2))umol/L,P = 0.660(> 0.05).The serum TBA level of group A was lower than that of group B(2.2(1.6,3.5)VS(3.35(2.23,5.15))umol/L,P =0.001(< 0.05),and the difference was statistically significant.Serum TBA level may be correlated with fasting insulin,homa-ir,free fatty acid,albumin,glutamate transaminase and platelet levels(all P < 0.05).Regression analysis of dichotomous variables showed that serum TBA may be positively correlated with the risk of liver fibrosis during NAFLD progression.(B: 0.278,P: 0.047,OR: 1.32,95CI% : 1.004-1.737).Conclusions: Our data showed that serum TBA levels did not change significantly in the control group and NAFLD patients.With the progress of the disease,TBA levels were higher in the medium-high risk group with fibrosis than in the non-progressive group.Serum TBA may be related to glucose and lipid metabolism and liver function,and increased TBA level may be a risk factor for progression of fibrosis risk in NAFLD.It may be a non-invasive biochemical indicator that has certain guiding significance in determining the degree of liver fibrosis in NAFLD patients.Early intervention of bile acid metabolism may be a new approach for prevention and progression of NAFLD.