非酒精性脂肪性肝病患者血清OCN、β-CTX和血管紧张素水平变化及其临床意义探讨*

doi:10.3969/j.issn.1672-5069.2025.03.015

摘要/Abstract

摘要： 目的探讨非酒精性脂肪性肝病(NAFLD)患者血清骨钙素(OCN)、β-Ⅰ型胶原羧基端肽(β-CTX)和血管紧张素Ⅱ(Ang-Ⅱ)水平变化及其临床意义。方法 2022年6月～2023年12月我院诊治的101例NAFLD患者【包括单纯性脂肪肝(SFL)32例,非酒精性脂肪性肝炎(NASH)50例和脂肪性肝硬化19例)】和同期53例健康体检者,使用Fibroscan Q瞬时弹性扫描仪行肝硬度检测(LSM)和受控衰减参数(CAP),采用ELISA法检测血清OCN水平,采用Cobas E 411电化学发光免疫分析仪检测血清β-CTX水平,采用A2000-PLUS全自动化学发光分析仪检测血清Ang-Ⅱ水平。结果 SFL组CAP显著高于健康人(P＜0.05),NASH组和肝硬化组血清ALT和AST水平及LSM和CAP显著高于SFL组或健康人(P＜0.05),肝硬化组LSM显著高于NASH组(P＜0.05);NASH组血清OCN和β-CTX水平分别为 (17.3±6.3)ng/mL和(0.3±0.1)ng/mL,均显著低于SFL组【分别为(22.8±6.4)ng/mL和(0.4±0.2)ng/mL,P＜0.05】,而血清Ang-Ⅱ水平为(2.7±0.5)μg/L,显著高于SFL组【(2.4±0.4)μg/L,P＜0.05】;肝硬化组血清Ang-Ⅱ水平为(3.0±0.6)μg/L,显著高于NASH组(P＜0.05);19例进展性肝纤维化患者血清OCN和β-CTX水平分别为(16.0±6.9)ng/mL和(0.2±0.1)ng/mL,显著低于31例显著性肝纤维化患者【分别为(19.6±6.0)ng/mL和(0.4±0.1)ng/mL,P＜0.05】,而血清Ang-Ⅱ水平为(3.1±1.5)μg/L,显著高于显著性肝纤维化患者【(2.5±0.7)μg/L,P＜0.05】。结论 NAFLD患者血清OCN、β-CTX和Ang-Ⅱ水平出现异常变化,可能对判断病情有帮助,值得深入研究。

关键词: 非酒精性脂肪性肝病, 非酒精性脂肪性肝炎, 肝纤维化, 骨钙素, β-Ⅰ型胶原羧基端肽, 血管紧张素, 临床意义

Abstract: Objective The aim of this study was to explore implication of serum osteocalcin (OCN), β-I type collagen carboxy-terminal peptide (β-CTX) and angiotensin-II(Ang-II) levels in patients with non-alcoholic fatty liver diseases(NAFLD). Methods 101 patients with NAFLD, including simple fatty liver (SFL) in 32 cases, nonalcoholic steatohepatitis (NASH) in 50 cases and fatty-related liver cirrhosis (LC) in 19 cases, and 53 healthy individuals who underwent for physical examinations were enrolled in our hospital between June 2022 and December 2023, and all received Fibroscan scan for liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). Serum OCN level was detected by ELISA, serum β-CTX level was determined by electrochemiluminescence immunoassay, and serum Ang-II level was measured by using fully automated chemiluminescence instrument. Results CAP in patients with SFL was much higher than in healthy control(P＜0.05), serum ALT and AST levels, as well as LSM and CAP in patients with NASH and with LC were much higher than in patients with SFL or healthy individuals (P＜0.05), and LSM in patients with LC was much higher than in with NASH(P＜0.05); serum OCN and β-CTX levels in patients with NASH were (17.3±6.3)ng/mL and (0.3±0.1)ng/mL, both significantly lower than [ (22.8±6.4)ng/mL and (0.4±0.2)ng/mL, respectively, P＜0.05] in patients with SFL, while serum Ang-Ⅱ level was (2.7±0.5)μg/L, significantly higher than [(2.4±0.4)μg/L, P＜0.05] in patients with SFL; serum Ang-Ⅱ level in patients with LC was (3.0±0.6)μg/L, much higher than in with NASH(P＜0.05); serum OCN and β-CTX levels in 19 patients with advanced liver fibrosis were(16.0±6.9)ng/mL and (0.2±0.1)ng/mL, both significantly lower than [(19.6±6.0)ng/mL and (0.4±0.1)ng/mL, respectively, P＜0.05], while serum Ang-Ⅱ level was (3.1±1.5)μg/L, much higher than [(2.5±0.7)μg/L, P＜0.05] in 31 patients with significant liver fibrosis. Conclusion Abnormal changes of serum OCN, β-CTX and Ang-II levels in patients with NAFLD is common, which might help assess steatosis and fibrosis.

Key words: Non-alcoholic fatty liver diseases, Nonalcoholic steatohepatitis, Liver fibrosis, Osteocalcin, β-I type collagen carboxy-terminal peptide, Angiotensin, Clinical implication

王新田, 康晓波, 吴霞, 韦颖. 非酒精性脂肪性肝病患者血清OCN、β-CTX和血管紧张素水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2025, 28(3): 378-381.

Wang Xintian, Kang Xiaobo, Wu Xia, et al. Changes of serum osteocalcin,β-I type collagen carboxy-terminal peptide and angiotensin levels in patients with non-alcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2025, 28(3): 378-381.

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非酒精性脂肪性肝病患者血清OCN、β-CTX和血管紧张素水平变化及其临床意义探讨^*

Changes of serum osteocalcin,β-I type collagen carboxy-terminal peptide and angiotensin levels in patients with non-alcoholic fatty liver diseases

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