Yoneda Masato, Uchiyama Takashi, Kato Shingo, Endo Hiroki, Fujita Koji, Yoneda Kyoko, Mawatari Hironori, Iida Hiroshi, Takahashi Hirokazu, Kirikoshi Hiroyuki, Inamori Masahiko, Nozaki Yuichi, Kobayashi Noritoshi, Kubota Kensuke, Saito Satoru, Maeyama Shiro, Sagara Mina, Aburatani Hiroyuki, Kodama Tatsuhiko, Nakajima Atsushi
Division of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Yokohama, Japan.
BMC Gastroenterol. 2008 Nov 14;8:53. doi: 10.1186/1471-230X-8-53.
The changes in the liver in nonalcoholic fatty liver disease (NAFLD) range over a wide spectrum, extending from steatosis to steatohepatitis (NASH). However it has remained difficult to differentiate between NASH and non-progressive NAFLD on the basis of the clinical findings alone.
In this study we investigated the clinical usefulness of plasma Pentraxin3 (PTX3) levels to predict NASH. Plasma PTX3 was measured in 70 patients with histologically verified NAFLD (28 with non-NASH and 42 with NASH) and 10 healthy control subjects.
The plasma PTX3 level was significantly higher in the NASH cases than in the non-NASH cases (p = 0.0021) and control subjects (p = 0.045). And the plasma PTX3 level was significantly higher in the stages 3-4 NAFLD cases than in the stages 0-2 NAFLD cases (p < 0.0001). The PTX3 values were closely correlated with the stages of liver fibrosis (p < 0.0001, Kruskal-Wallis test). To detect NASH compared with non-NASH, the area under the curve for plasma PTX3 were 0.755, and to detect stages 3-4 NAFLD compared with stages 0-2 NAFLD, the area under the curve for plasma PTX3 were 0.850.
This is the first study to demonstrate consistent and profound elevation of plasma PTX3 levels in NASH in comparison with non-NASH. The results suggest that plasma PTX3 levels may not only be laboratory values that differentiate NASH from non-NASH, but marker of the severity of hepatic fibrosis in NASH.
非酒精性脂肪性肝病（NAFLD）患者的肝脏变化范围广泛，从脂肪变性到脂肪性肝炎（NASH）。然而，仅根据临床发现仍难以区分NASH和非进展性NAFLD。
在本研究中，我们调查了血浆五聚体3（PTX3）水平预测NASH的临床实用性。对70例经组织学证实为NAFLD的患者（28例非NASH患者和42例NASH患者）及10名健康对照者测定了血浆PTX3水平。
NASH患者的血浆PTX3水平显著高于非NASH患者（p = 0.0021）和对照者（p = 0.045）。3-4期NAFLD患者的血浆PTX3水平显著高于0-2期NAFLD患者（p < 0.0001）。PTX3值与肝纤维化分期密切相关（p < 0.0001，Kruskal-Wallis检验）。与非NASH相比，检测NASH时血浆PTX3的曲线下面积为0.755；与0-2期NAFLD相比，检测3-4期NAFLD时血浆PTX3的曲线下面积为0.850。
本研究首次证明，与非NASH相比，NASH患者血浆PTX3水平持续且显著升高。结果表明，血浆PTX3水平不仅可能是区分NASH与非NASH的实验室指标，而且是NASH肝纤维化严重程度的标志物。
