摘要目的:探讨单次高脂餐前后血清NOD样受体蛋白3（NLRP3）水平与代谢相关脂肪性肝病（MAFLD）患者血清脂质水平变化的相关性。方法:回顾性队列研究。纳入从2019年2月至12月于河北省人民医院招募的63例MAFLD患者（MAFLD组）和54名健康受试者（CON组），比较两组基线资料，并进行单次高脂餐试验。检测空腹及高脂餐后2 h、4 h、6 h的总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和NLRP3水平。采用多重线性回归分析评估血清NLRP3受试者操作特征曲线下面积（AUC）的影响因素。采用logistic回归分析评估血清AUC NLRP3与MAFLD患病风险的相关性。 结果:MAFLD组空腹及高脂餐后2 h、4 h、6 h的总胆固醇、甘油三酯、LDL-C和NLRP3水平均较CON组明显升高［总胆固醇（mmol/L），空腹：（5.29±1.01）比（4.28±0.62），2 h：（5.24±0.98）比（4.25±0.62），4 h：（5.38±1.04）比（4.26±0.63），6 h：（5.54±1.07）比（4.41±0.65）；甘油三酯（mmol/L），空腹：（2.67±0.96）比（0.92±0.33），2 h：（3.91±1.35）比（1.69±0.59），4 h：（5.09±1.7）比（1.91±0.93），6 h：（5.36±2.27）比（1.75±1.03）；LDL-C（mmol/L），空腹：（3.47±0.74）比（2.65±0.49），2 h：（3.36±0.71）比（2.58±0.49），4 h：（3.30±0.71）比（2.55±0.47），6 h：（3.36±0.74）比（2.63±0.48）；NLRP3（ng/L），空腹：（84.63±12.96）比（56.71±11.37）、2 h：（106.06±17.76）比（69.12±14.92）、4 h：（89.78±15.98）比（57.74±12.34）、6 h：（80.03±13.61）比（54.06±10.35）； P值均＜0.001］，HDL-C水平较CON组明显降低［HDL-C（mmol/L），空腹：（1.14±0.24）比（1.33±0.29），2 h：（1.14±0.24）比（1.33±0.29），4 h：（1.09±0.24）比（1.27±0.28），6 h：（1.05±0.26）比（1.29±0.30）； P值均＜0.001］。校正混杂因素后，血清AUC NLRP3分别与AUC 甘油三酯和AUC LDL-C呈明显相关性（AUC 甘油三酯： B=7.391，95% CI：5.662～9.120；AUC LDL-C： B=6.559，95% CI：3.052～10.065； P值均＜0.001）。且AUC NLRP3是MAFLD的独立影响因素（ OR=1.039，95% CI：1.007～1.071， P=0.015）。 结论:单次高脂餐前后血清NLRP3水平与甘油三酯、LDL-C升高明显相关，可影响MAFLD的疾病进展。

abstractsObjective:To investigate the correlation between serum NOD-like receptor protein 3 (NLRP3) levels and serum lipids in metabolic-associated fatty liver disease (MAFLD) before and after a single high-fat meal.Methods:A retrospective cohort study was conducted. Sixty-three MAFLD patients (MAFLD group) and fifty-four healthy subjects (CON group) recruited from February 2019 to December 2019 at Hebei Provincial People's Hospital were included. The baseline data were compared between the two groups, and a single high-fat meal trial was conducted. The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and NLRP3 were measured at 2 h, 4 h, and 6 h after fasting and a high-fat meal. Multiple linear regression analysis was used to evaluate the influencing factors of area under the operating curve (AUC NLRP3) of serum NLRP3 subjects. Logistic regression analysis was used to evaluate the correlation between serum AUC NLRP3 and the risk of MAFLD. Results:The levels of TC, TG, LDL-C, and NLRP3 were significantly higher in the fasting group than the CON group at 2 h, 4 h, and 6 h after a meal [TC (mmol/L), fasting: (5.29±1.01) vs. (4.28±0.62), 2 h: (5.24±0.98) vs. (4.25±0.62), 4 h: (5.38±1.04) vs. (4.26±0.63), 6 h: (5.54±1.07) vs. (4.41±0.65); TG (mmol/L), fasting: (2.67±0.96) vs. (0.92±0.33), 2 h: (3.91±1.35) vs. (1.69±0.59), 4 h: (5.09±1.7) vs. (1.91±0.93), 6 h: (5.36±2.27) vs. (1.75±1.03); LDL-C (mmol/L), fasting: (3.47±0.74) vs. (2.65±0.49), 2 h: (3.36±0.71) vs. (2.58±0.49), 4 h: (3.30±0.71) vs. (2.55±0.47), 6 h: (3.36±0.74) vs. (2.63±0.48); NLRP3 (ng/L), fasting: (84.63±12.96) vs. (56.71±11.37), 2 h: (106.06±17.76) vs. (69.12±14.92), 4 h: (89.78±15.98) vs. (57.74±12.34), 6 h: (80.03±13.61) vs. (54.06±10.35); P<0.001], while the HDL-C level was significantly lower than the CON group [HDL-C (mmol/L), fasting: (1.14±0.24) vs. (1.33±0.29), 2 h: (1.14±0.24) vs. (1.33±0.29), 4 h: (1.09±0.24) vs. (1.27±0.28), and 6 h: (1.05±0.26) vs. (1.29±0.30); P<0.001]. Serum AUC NLRP3 was significantly correlated with AUC TG and AUC LDL-C (AUC TG: B=7.391, 95% CI:5.662-9.12; AUC LDL-C: B=6.559, 95% CI:3.052-10.065; P<0.001) after adjusting for confounding factors, and it was identified as an independent influencing factor for MAFLD ( OR=1.039, 95% CI:1.007-1.071; P=0.015). Conclusion:The serum NLRP3 levels before and after a single high-fat meal are significantly associated with elevated TG and LDL-C levels, and may influence the progression of MAFLD.