| Objective:By comparing the differences of ET-1,NO and other indexes among NAFLD patients with different degrees of fibrosis,we explored the relationship between the progression of liver fibrosis in NAFLD and ET-1/NO,so as to clarify whether the progression of fibrosis would have an effect on endothelial function.Methods:In this study,408 outpatients/inpatients in the Department of Hepatology,Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from April 2019 to October 2020 were collected,and 280NAFLD patients were included strictly according to the inclusion criteria and exclusion criteria of this subject.Collecting general data such as gender,age,height and weight of patients,including TCM syndrome types and serological index data.And then,calculating the body mass index[BMI=weight(kg)/height ~2(m~2)].Using the Fibro Touch detector to further test the liver stiffness value(LSM)and fat attenuation(FAP)of patients diagnosed with fatty liver by B-ultrasound,and made a record.SPSS 22.0 statistical software was used to analyze the differences of serum indexes such as ET-1,NO and general data in different fibrosis degrees of NAFLD patients in each group;Spearman analysis was used to analyze the correlation between LSM value and ET-1,NO and so on.Also,the same method was used to analyze the correlation between ET-1,NO and each index;Binary Logistic regression analysis was used to analyze the influencing factors of fibrosis progression(LSM value increased))in NAFLD;To summarize the distribution of TCM syndrome types and factors of NAFLD patients.Results:1.According to the LSM value,280 patients with NAFLD were divided into no or very light liver fibrosis group and liver fibrosis group,advanced liver fibrosis group and severe fibrosis group.It was found that the LSM value was statistically significant compared with BMI,FAP,ALT,AST,GGT,TG and HDL-C(P<0.05).The LSM value was positively correlated with BMI,FAP,ALT,AST and GGT(r_s>0),and negatively correlated with TG and HDL-C(r_s<0).2.According to LSM value,patients with NAFLD were divided into two different fibrosis stages:no or very lijght liver fibrosis and liver fibrosis,non-advanced fibrosis and advanced fibrosis.In the stage of no or very light liver fibrosis and liver fibrosis,Logistic regression analysis showed that age,FAP and ALT were risk factors for NAFLD fibrosis progression(LSM increased).In the stage of non-advanced fibrosis and advanced fibrosis,Logistic regression analysis showed that HDL-C was a protective factor of fibrosis progression(LSM increased)in NAFLD patients.3.In different stages of fibrosis,there was no significant difference between LSM and ET-1/NO in each group(P>0.05).Spearman analysis showed that ET-1 was not correlated with age,NO,ALT,AST,GGT,CHOL,TG,HDL-C,LDL-C,LSM,FAP and BMI(P>0.05),and NO was not correlated with age,ET-1,ALT,AST,GGT,CHOL,TG,HDL-C,LDL-C,LSM,FAP and BMI(P>0.05).4.Our study showed that the most common Traditional Chinese Medicine syndrome types of NAFLD were liver stagnation and spleen deficiency syndrome and phlegm dampness trapping spleen syndrome,followed by damp-heat accumulation syndrome,Qi stagnation and blood stasis syndrome,and spleen-kidney Yang deficiency syndrome.The location of disease syndrome factors were liver,spleen and kidney.Dampness,Qi stagnation and Qi deficiency were the most common nature of disease factors,followed by phlegm,heat,blood stasis and Yang deficiency.Conclusion:The LSM value of NAFLD patients diagnosed by Fibro Touch may be affected by age,BMI,FAP,ALT,AST,GGT,TG and HDL-C;For NAFLD patients,the influencing factors of LSM value may be different in different stages of liver fibrosis;Age,FAP and ALT are risk factors for NAFLD fibrosis progression(LSM increased),HDL-C is a protective factor for NAFLD fibrosis progression(LSM increased);The fibrosis progression of NAFLD has no effect on ET-1 and NO,suggesting that the fibrosis progression of NAFLD may have no effect on endothelial function;The distribution of NAFLD syndrome types are mainly liver stagnation and spleen deficiency syndrome and phlegm dampness trapping spleen syndrome;The location of disease syndrome factors are liver,spleen and kidney;Dampness,Qi stagnation and Qi deficiency are the most common nature of disease factors. |
