代谢相关脂肪性肝病患者血清HIF-1α、Chemerin和脂联素水平变化及临床意义探讨*

doi:10.3969/j.issn.1672-5069.2023.05.013

摘要/Abstract

摘要： 目的分析代谢相关脂肪性肝病(MAFLD)患者血清缺氧诱导因子-1α(HIF-1α)、Chemerin和脂联素(ADPN)水平变化及其临床意义。方法 2020年3月～2022年10月我院诊治的MAFLD患者86例和同期经年龄和性别匹配的健康体检者43例,应用超声检查评估肝脂肪变程度,采用ELISA法检测血清HIF-1α、Chemerin和ADPN水平,应用受试者工作特征曲线下面积(AUC)分析血清指标评估MAFLD患者肝重度脂肪变的效能。结果 MAFLD组血清HIF-1α和Chemerin水平分别为(16.6±3.1)μg/L和(92.7±8.9)μg/L,均显著高于对照组【分别为(9.2±2.1)μg/L和(60.4±9.5)μg/L,均P<0.05】,而血清ADPN水平为(15.1±3.8)mg/L,显著低于对照组【(25.4±6.2)mg/L,P<0.05】;35例重度脂肪变MAFLD患者血清HIF-1α和Chemerin水平分别为(19.9±3.7)μg/L和(107.9±10.5)μg/L,显著高于29例中度脂肪变患者【分别为(16.3±1.9)μg/L和(92.9±8.7)μg/L,P<0.05】或22例轻度脂肪变患者【分别为(10.5±1.8)μg/L和(84.0±8.3)μg/L,P<0.05】,而血清ADPN水平为(12.3±2.8)mg/L,显著低于中度脂肪变患者【(16.4±4.8)mg/L,P<0.05】或轻度脂肪变患者【(24.2±4.2)mg/L,P<0.05】;多因素Logistic回归分析显示,空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、HIF-1α和Chemerin高水平及ADPN低水平是MAFLD患者发生肝重度脂肪变的独立危险因素(P<0.05); 联合应用血清HIF-1α、Chemerin和ADPN水平评估肝重度脂肪变的AUC为0.920,显著高于三项指标单一评估的0.846、0.742和0.795(P<0.05)。结论 MAFLD患者存在血清HIF-1α和Chemerin升高及ADPN水平下降,且三者变化与肝脂肪变程度相关,其临床意义值得进一步探究。

Abstract: Objective The aim of this study was to explore the changes of serum hypoxia-inducible factor-1α (HIF-1α), chemerin and adiponectin (ADPN) levels in patients with metabolic-associated fatty liver diseases (MAFLD). Methods 86 patients with MAFLD and 43 healthy individuals at physical healthy examination matched by age and gender were consecutively encountered in our hospital between March 2020 and October 2022. Serum levels of HIF-1α, Chemerin and ADPN were detected by ELISA, and the hepatic steatosis was evaluated by ultrasonography. The area under the receiver operating characteristic curve (AUC) was applied to analyze the diagnostic performance of serum indicators on severe steatosis in patients with MAFLD. Results Serum HIF-1α and chemerin levels in patients with MAFLD were (16.6±3.1)μg/L and (92.7±8.9)μg/L, both significantly higher than [(9.2±2.1)μg/L and (60.4±9.5)μg/L, P<0.05] in the control, while serum ADPN level was (15.1±3.8)mg/L, significantly lower than [(25.4±6.2)mg/L, P<0.05] in the control; serum HIF-1α and chemerin levels in 35 patients with severe hepatic steatosis were (19.9±3.7)μg/L and (107.9±10.5)μg/L, both significantly higher than [(16.3±1.9)μg/L and (92.9±8.7)μg/L, P<0.05] in 29 patients with moderate liver steatosis or [(10.5±1.8)μg/L and (84.0±8.3)μg/L, P<0.05] in 22 patients with mild steatosis, while serum ADPN level was (12.3±2.8)mg/L, much lower than [(16.4±4.8)mg/L, P<0.05] in patients with moderate steatosis or [(24.2±4.2)mg/L, P<0.05] in patients with mild steatosis; the multivariate Logistic regression analysis showed that the fasting blood glucose, triglyceride, total cholesterol, low-density lipoprotein cholesterol, HIF-1α and chemerin and low level of ADPN were the independent risk factors for severe steatosis in patients with MAFLD (P<0.05); the AUC was 0.920 by the combination of serum HIF-1α, chemerin and ADPN levels in predicting severe steatosis in patients with MAFLD, much larger than 0.846, 0.742 and 0.795(P<0.05) by the three parameter alone. Conclusion Serum HIF-1α and chemerin levels increase, while serum ADPN level decrease in patients with MAFLD, and the changes of the above three parameters are related to the steatosis degree in patients with MAFLD, and their clinical implications are worthy of further investigation.

Key words: Metabolic-associated fatty liver disease, Hypoxia-inducible factor-1α, Chemerin, Adiponectin, Diagnosis

蔡欣, 辛春红, 牛洪凯, 兰春祥. 代谢相关脂肪性肝病患者血清HIF-1α、Chemerin和脂联素水平变化及临床意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(5): 654-657.

Cai Xin, Xin Chunhong, Niu Hongkai, et al. Changes of serum HIF-1α, Chemerin and adiponectin levels in patients with metabolic-associated fatty liver diseases[J]. Journal of Practical Hepatology, 2023, 26(5): 654-657.

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代谢相关脂肪性肝病患者血清HIF-1α、Chemerin和脂联素水平变化及临床意义探讨^*

Changes of serum HIF-1α, Chemerin and adiponectin levels in patients with metabolic-associated fatty liver diseases

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