血清学指标和脂肪肝指数诊断非酒精性脂肪性肝病价值分析*

doi:10.3969/j.issn.1672-5069.2020.02.016

摘要/Abstract

摘要： 目的探讨应血清指标和脂肪肝指数(FLI)诊断非酒精性脂肪性肝病(NAFLD)患者的价值。方法 2016年3月～2019年3月我院肝病科诊治的NAFLD 患者86例和同期进行体检的健康人群86例,检测血清胰脂肪酶(P-LIP)、降钙素原(PCT)、C反应蛋白(CRP),计算FLI。结果 NAFLD患者血清PCT和CRP水平及FLI分别为(0.10±0.05) μg/L、(5.6±1.0)μg/L和(37.4±3.6),显著高于健康人【分别为(0.04±0.02)μg/L、(2.8±0.7)μg/L和(18.2±1.3),P<0.05】,而血清P-LIP水平为(27.1±2.4)U/L,显著低于健康人【(35.8±3.2)U/L,P<0.05】;18例非酒精性脂肪肝肝炎(NASH)相关肝硬化患者血清PCT、CRP、P-LIP和FLI分别为(0.18±0.07)μg/L、(7.4±1.2)μg/L、(22.9±1.7)U/L和39.41±4.0,与33例NASH患者【分别为(0.11±0.04)μg/L、(4.8±0.5)μg/L、(27.7±2.2)U/L和(38.0±3.7)比或与35例单纯性脂肪肝患者【分别为(0.07±0.02)μg/L、(3.0±0.3)μg/L、(34.2±2.6)U/L和(35.8±3.4)比,差异显著(P<0.05);FLI诊断NAFLD的灵敏度和特异度分别为76.7%和73.3%,而FLI联合血清CRP、PCT和P-LIP诊断的灵敏度和特异度分别为66.3%和86.1%。结论 FLI诊断NAFLD患者具有一定的临床应用价值,联合其他一些血清指标可能有助于提高诊断效率。

关键词: 非酒精性脂肪性肝病, 脂肪肝指数, 降钙素原, 血清胰脂肪酶, 诊断

Abstract: Objective The purpose of this study was to explore the diagnostic value of serological indexes and fatty liver index (FLI) in patients with nonalcoholic fatty liver diseases (NAFLD). Methods 86 patients with NAFLD and 86 healthy persons were recruited in our Department between March 2016 to March 2019, and serum pancreatic lipase (P-LIP), procalcitonin (PCT), C-reactive protein (CRP) were assayed, and fatty liver index (FLI) was calculated. Results Serum PCT and CRP levels as well as FLI in patients were (0.10±0.05) μg/L,(5.6±1.0)μg/L and (37.4±3.6), significantly higher than 【(0.04±0.02)μg/L,(2.8±0.7)μg/L and (18.2±1.3), respectively, P<0.05】, while serum P-LIP level was (27.1±2.4)U/L, much lower than 【(35.8±3.2)U/L, P<0.05】 in healthy individuals; serum PCT, CRP, P-LIP and FLI in 18 patients with non-alcoholic steatohepatitis (NASH)-related cirrhosis were (0.18±0.07)μg/L, (7.4±1.2)μg/L, (22.9±1.7)U/L and 39.41±4.0, significantly different as compared to 【(0.11±0.04)μg/L, (4.8±0.5)μg/L, (27.7±2.2)U/L and (38.0±3.7), respectively, in 33 patients with NASH or 【(0.07±0.02)μg/L, (3.0±0.3)μg/L, (34.2±2.6)U/L and (35.8±3.4), respectively, in 35 patients with single non-alcoholic fatty liver(P<0.05); the sensitivity (Se) and specificity (Sp) of FLI in diagnosing NAFLD were 76.7% and 73.3%, while they were 66.3% and 86.1% when combination of FLI with serumCRP, PCT and P-LIP. Conclusion The application of FLI is a simple way to diagnose patients with NAFLD , and the combination of serum index might improve the diagnostic efficiency.

Key words: Non-alcoholic fatty liver disease, Fatty liver index, Procalcitonin, Pancreatic lipase, Diagnosis

曾震军, 李墨航. 血清学指标和脂肪肝指数诊断非酒精性脂肪性肝病价值分析^*[J]. 实用肝脏病杂志, 2020, 23(2): 211-214.

Zeng Zhenjun, Li Mohang. Diagnostic value of serological indexes and fatty liver index inpatients with nonalcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2020, 23(2): 211-214.

参考文献

[1] Assunçã o SNF, Sorte NCB, Alves CD, et al. Nonalcoholic fatty liver disease (nafld) pathophysiology in obese children and adolescents: update. Nutr Hosp, 2017, 34(3): 727-730.
[2] 田军伟, 肖远力, 王艳超. 应用血清TG/HDL-C比值早期诊断非酒精性脂肪性肝病患者临床价值探讨. 实用肝脏病杂志, 2017, 20(4): 416-419.
[3] Tsai E, Lee TP. Diagnosis and evaluation of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, including noninvasive biomarkers and transient elastography. Clin Liver Dis, 2018, 22(1): 73-92.
[4] Satoi S, Sho M, Yanagimoto H, et al. Do pancrelipase delayed-release capsules have a protective role against nonalcoholic fatty liver disease after pancreatoduodenectomy in patients with pancreatic cancer? A randomized controlled trial. J Hepatobiliary Pancreat Sci, 2016, 23(3): 167-173.
[5] Bai PS, Xia N, Sun H, et al. Pleiotrophin, a target of miR-384, promotes proliferation, metastasis and lipogenesis in HBV-related hepatocellular carcinoma. J Cell Mol Med, 2017, 21(11): 3023-3043.
[6] Cuomo G, Borghi V, Giuberti T, et al. What to start with in first line treatment of chronic hepatitis B patients: an Italian multicentre observational cohort, HBV-RER study group. Infez Med, 2017, 25(2): 150-157.
[7] Jung CH, Kang YM, Jang JE, et al. Fatty liver index is a risk determinant of incident type 2 diabetes in a metabolically healthy population with obesity. Obesity (Silver Spring), 2016, 24(6): 1373-1379.
[8] Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism, 2016, 65(8): 1038-1048.
[9] Germani G, Becchetti C. Liver transplantation for non-alcoholic fatty liver disease. Minerva Gastroenterol Dietol, 2018, 64(2): 138-146.
[10] Carr RM, Patel A, Bownik H, et al. Intestinal inflammation does not predict nonalcoholic fatty liver disease severity in inflammatory bowel disease patients. Dig Dis Sci, 2017, 62(5): 1354-1361.
[11] Augustin S, Graupera I, Caballeria J. Non-alcoholic fatty liver disease: A poorly known pandemic. Med Clin (Barc), 2017, 149(12): 542-548.
[12] Ou R, Liu J, Lyu M, et al. Neutrophil depletion improves diet-induced non-alcoholic fatty liver disease in mice. Endocrine, 2017, 57(1): 72-82.
[13] Blyszczuk P, Müller-Edenborn B, Valenta T, et al. Transforming growth factor-β-dependent Wnt secretion controls myofibroblast formation and myocardial fibrosis progression in experimental autoimmune myocarditis. Eur Heart J, 2017, 38(18): 1413-1425.
[14] Shin JM, Park JH, Kang B, et al. Effect of doxycycline on transforming growth factor-beta-1-induced matrix metalloproteinase 2 expression, migration, and collagen contraction in nasal polyp-derived fibroblasts. Am J Rhinol Allergy, 2016, 30(6): 385-390.
[15] Kochan K, Kus E, Szafraniec E, et al. Changes induced by non-alcoholic fatty liver disease in liver sinusoidal endothelial cells and hepatocytes: spectroscopic imaging of single live cells at the subcellular level. Analyst, 2017, 142(20): 3948-3958.
[16] Lăpădat AM, Jianu IR, Ungureanu BS, et al. Non-invasive imaging techniques in assessing non-alcoholic fatty liver disease: a current status of available methods. J Med Life, 2017, 10(1): 19-26.
[17] Grasselli E, Canesi L, Portincasa P, et al. Models of non-alcoholic fatty liver disease and potential translational value: the effects of 3,5-l-diiodothyronine. Ann Hepatol, 2017, 16(5): 707-719.
[18] Parry SA, Hodson L. Influence of dietary macronutrients on liver fat accumulation and metabolism. J Investig Med, 2017, 65(8): 1102-1115.
[19] Jin CJ, Engstler AJ, Ziegenhardt D, et al. Loss of lipopolysaccharide-binding protein attenuates the development of diet-induced non-alcoholic fatty liver disease in mice. J Gastroenterol Hepatol, 2017, 32(3): 708-715.
[20] 管军, 徐烨. 青少年非酒精性脂肪肝相关危险因素分析. 实用肝脏病杂志, 2017, 20(3): 347-349.
[21] Angelis-Pereira MC, Barcelos MFP, Pereira JAR, et al. Effect of different commercial fat sources on brain, liver and blood lipid profiles of rats in growth phase. Acta Cir Bras, 2017, 32(12): 1013-1025.
[22] Hamden K, Keskes H, Elgomdi O, et al. Modulatory effect of an isolated triglyceride from fenugreek seed oil on of α-amylase, lipase and ace activities, liver-kidney functions and metabolic disorders of diabetic rats. J Oleo Sci, 2017, 66(6): 633-645.
[23] You M, Zhou Z, Daniels M, et al. Endocrine adiponectin-fgf15/19 axis in ethanol-induced inflammation and alcoholic liver injury. Gene Expr, 2018, 18(2): 103-113.
[24] Leitão HS, Doblas S, Garteiser P, et al. Hepatic fibrosis, inflammation, and steatosis: influence on the mr viscoelastic and diffusion parameters in patients with chronic liver disease. Radiology, 2017, 283(1): 98-107.
[25] Wu L, Zhang Q, Mo W, et al. Quercetin prevents hepatic fibrosis by inhibiting hepatic stellate cell activation and reducing autophagy via the TGF-β1/Smads and PI3K/Akt pathways. Sci Rep, 2017, 7(1): 9289.
[26] Lee HS, Chung MJ, Park JY, et al. Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis. PLoS One, 2018, 13(2): e0190835.
[27] Potočnjak I, Trbušič M, Terešak SD, et al. Metabolic syndrome modulates association between endothelial lipase and lipid/lipoprotein plasma levels in acute heart failure patients. Sci Rep, 2017, 7(1): 1165.
[28] Sviklāne L, Olmane E, Dzērve Z, et al. Fatty liver index and hepatic steatosis index for prediction of non-alcoholic fatty liver disease in type 1 diabetes. J Gastroenterol Hepatol, 2018, 33(1): 270-276.
[29] Yang AP, Liu J, Yue LH, et al. Neutrophil CD64 combined with PCT, CRP and WBC improves the sensitivity for the early diagnosis of neonatal sepsis. Clin Chem Lab Med, 2016, 54(2): 345-351.
[30] Wang Q, Yan H, Wang G, et al. RNA sequence analysis of rat acute experimental pancreatitis with and without fatty liver: a gene expression profiling comparative study. Sci Rep, 2017, 7(1): 734.
[31] Sferra R, Vetuschi A, Pompili S, et al. Expression of pro-fibrotic and anti-fibrotic molecules in dimethylnitrosamine-induced hepatic fibrosis. Pathol Res Pract, 2017, 213(1): 58-65.
[32] Tang N, Zhang Y, Liu Z, et al. Correlation of four potential biomarkers of liver fibrosis with liver function and grade of hepatic fibrosis in a neonatal cholestatic rat model. Mol Med Rep, 2017, 16(1): 415-421.

血清学指标和脂肪肝指数诊断非酒精性脂肪性肝病价值分析^*

Diagnostic value of serological indexes and fatty liver index inpatients with nonalcoholic fatty liver diseases

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