非酒精性脂肪性肝病患者血清IL-1RA、CTRP13和CK-18水平变化及其临床意义探讨*

doi:10.3969/j.issn.1672-5069.2024.02.007

摘要/Abstract

摘要： 目的探讨非酒精性脂肪性肝病(NAFLD)患者血清白细胞介素-1受体拮抗剂(IL-1RA)、补体C1q肿瘤坏死因子相关蛋白13(CTRP13)和细胞角蛋白18(CK-18)水平变化及其临床意义。方法 2021年1月～2023年1月我院收治的67例NAFLD患者和55例健康体检者, 经肝活检诊断肝脏脂肪变性分级, 采用ELISA法检测血清IL-1RA、CTRP13和CK-18水平。应用多元Logistic回归分析危险因素。结果 NAFLD组血清IL-1RA和CTRP13水平分别为(328.6±54.3)pg/ml和(2634.2±397.5)pg/ml, 显著低于健康人组【分别为(673.1±125.4)pg/ml和(3425.7±423.8)pg/ml, P<0.05】, 而血清CK-18水平为(15.2±3.1)ng/ml, 显著高于健康人组【(3.9±0.7)ng/ml, P<0.05】;17例F3级肝脂肪变性患者血清IL-1RA和CTRP13水平分别为(256.3±47.6)pg/ml和(2056.3±308.4)pg/ml, 显著低于29例F1级患者【分别为(388.3±59.4)pg/ml和(3071.5±409.3)pg/ml, P<0.05】或21例F2级患者【分别为(304.7±50.1)pg/ml和(2498.1±374.2)pg/ml, P<0.05】, 而血清CK-18水平为(23.4±4.7)ng/ml, 显著高于F1级患者【(8.1±1.3)ng/ml, P<0.05】或F2级患者【(18.5±2.9)ng/ml, P<0.05】;F3级肝脂肪变性患者肥胖、合并糖尿病、合并高脂血症、有代谢综合征家族史、血清IL-1RA≥256.5pg/ml、CTRP13≥2056.5pg/ml 和CK-18≥21.6 ng/ml占比分别为70.6%、76.5%、88.2%、70.6%、35.3%、35.3%和70.6%, 与50例F1/F2级的38.0%、42.0%、40.0%、30.0%、92.0%、80.0%和10.0%比, 差异显著(P<0.05);多因素Logistic回归分析表明, 肥胖【OR(95%)为2.0(1.1～3.6)】、合并糖尿病【OR(95%)为2.1(1.1～4.1)】、合并高脂血症【OR(95%)为1.6(1.0～2.6)】、IL-1RA【OR(95%)为0.5(0.3～0.9)】、CTRP13【OR(95%)为0.5(0.3～0.9)】和CK-18【OR(95%)为1.7(1.2～2.5)】为影响NAFLD患者肝脏脂肪变性程度的危险因素(P<0.05)。结论 NAFLD患者血清IL-1RA、CTRP13和CK-18水平异常变化可能为评估肝脏脂肪变性程度提供一定的依据。

关键词: 非酒精性脂肪性肝病, 白细胞介素-1受体拮抗剂, 补体C1q肿瘤坏死因子相关蛋白13, 细胞角蛋白18, 临床意义

Abstract: Objective The aim of this study was to explore the clinical implications of serum interleukin-1 receptor antagonist (IL-1RA), complement C1q tumor necrosis factor related protein 13 (CTRP13) and cytokeratin 18 (CK-18) levels in patients with non-alcoholic fatty liver diseases (NAFLD). Methods 67 patients with NAFLD and 55 healthy individuals at physical examination were enrolled in our hospital between January 2021 and January 2023, and all patients received liver biopsies for hepatic steatosis classification. Serum IL-1RA, CTRP13 and CK-18 levels were detected by ELISA, and the risk factors for severe liver steatosis was determined by multivariate Logistic regression analysis. Results Serum IL-1RA and CTRP13 levels in patients with NAFLD were (328.6±54.3)pg/ml and (2634.2±397.5)pg/ml, both significantly lower than [(673.1±125.4)pg/ml and (3425.7±423.8)pg/ml, P<0.05], while serum CK-18 level was (15.2±3.1)ng/ml, significantly higher than in healthy persons; serum IL-1RA and CTRP13 levels in 17 patients with severe liver steatosis of F3 were (256.3±47.6)pg/ml and (2056.3±308.4) pg/ml, significantly lower than [(388.3±59.4) pg/ml and (3071.5±409.3)pg/ml, P<0.05] in 29 patients with F1 steatosis or in 21 patients with F2 steatosis, while serum CK-18 level was (23.4±4.7)ng/ml, significantly higher than in patients with F1 or in patients with F2 steatosis; the percentages of concomitant obesity, diabetes mellitus, hyperlipidemia, family history of metabolic syndromes, low serum IL-1RA and CTRP13, and high serum CK-18 levels in patients F3 steatosis were 70.6%, 76.5%, 88.2%, 70.6%, 35.3%, 35.3% and 70.6%, significantly different compared to 38.0%, 42.0%, 40.0%, 30.0%, 92.0%, 80.0% and 10.0% in 50 patients with F1/F2 steatosis (P<0.05); the multivariate Logistic regression analysis showed that the obesity , diabetes , hyperlipidemia , low serum IL-1RA and CTRP13 and high serum CK-18 were the risk factors for severe liver steatosis in patients with NAFLD (P<0.05). Conclusion The abnormal changes of serum IL-1RA, CTRP13 and CK-18 levels in patients with NAFLD might help evaluate hepatic steatosis, and warrants further clinical investigation.

Key words: Non-alcoholic fatty liver diseases, Interleukin-1 receptor antagonist, Complement C1q tumor necrosis factor related protein 13, Cytokeratin 18, Implications

高洋, 张静, 卢宣霖. 非酒精性脂肪性肝病患者血清IL-1RA、CTRP13和CK-18水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2024, 27(2): 185-188.

Gao Yang, Zhang Jing, Lu Xuanlin. Changes of serum IL-1RA, CTRP13 and CK-18 levels in patients with non-alcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2024, 27(2): 185-188.

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非酒精性脂肪性肝病患者血清IL-1RA、CTRP13和CK-18水平变化及其临床意义探讨^*

Changes of serum IL-1RA, CTRP13 and CK-18 levels in patients with non-alcoholic fatty liver diseases

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