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摘要：
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摘要：目的 通过Meta分析评估非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）以
及其疾病谱 [包括单纯非酒精性脂肪肝（simple non-alcoholic fatty liver，NAFL）、非酒精性脂肪性
肝炎（non-alcoholic steatohepatitis，NASH）] 与健康对照组间血清同型半胱氨酸（homocysteine，
Hcy）水平的差异，为NAFLD的诊断和治疗提供参考。方法 从PubMed、Web of Science、CNKI、万
方数据和维普数据库中检索有关NAFLD与Hcy相关性的文献并提取数据，截止时间为2018年7月，
采用Newcastle Ottawa Scale（NOS）评估纳入文献的质量，采用RevMan5.3对数据进行合并统计分
析。结果 与对照组相比，NAFLD组（14篇文献）、NAFL组（4篇文献）及NASH组（6篇文献）患
者Hcy水平差异均有统计学意义（P均＜ 0.05）。NASH组和NAFL组患者Hcy水平差异无统计学意
义（4篇文献，SMD = 0.53，95% CI：-0.60～1.66，P = 0.36）。结论 NAFLD及其疾病谱（NAFL、
NASH）Hcy水平显著高于健康对照组，而NASH组与NAFL组Hcy水平基本相同。高同型半胱氨酸血
症（Hyperhomocysteinemia，HHCY）可能是NAFLD发病的重要危险因素，其或许可成为诊断NAFLD
的非侵入性标志物。然而尚不可以Hcy水平推断NAFLD病程是否从NAFL进展至NASH。
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Abstract: Objective A Meta-analysis was performed to evaluate the homocysteine (Hcy) level of patients
with non-alcoholic fatty liver disease (NAFLD) and its spectrum, including simple non-alcoholic fatty liver
(NAFL) and non-alcoholic steatohepatitis (NASH), and healthy controls in order to provide references for
the diagnosis and treatment of NAFLD. Methods Data were extracted from PubMed, Web of science, CNKI,
WanFang Database and VIP Database from inception to July 2018. Studies on the association between
NAFLD and Hcy were searched. The quality of literature were evaluated by Newcastle Ottawa Scale (NOS),
and Meta-analysis was conducted by RevMan5.3 software. Results Compared with healthy controls, the Hcy
levels in NAFLD group (14 studies), NAFL group (4 studies) and NASH group (6 studies) were statistically
significant (P ＜ 0.05). There was no significant difference in Hcy levels between NASH and NAFL group
(4 studies, SMD = 0.53, 95% CI：-0.60～1.66, P = 0.36). Conclusions The levels of Hcy in NAFLD and its
spectrum (NAFL and NASH) were significantly higher than those in control group. Hyperhomocysteinemia
(HHCY) may represent a risk factor for NAFLD and it might represent another non-invasive marker for the
assessment of NAFLD. However, it is not timely to conclude whether the course of NAFLD progresses from
NAFL to HASH by Hcy level.
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