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血清 TGF-β、血清 MMP-1 和 HOMA-IR 作为非侵入性预测因子在埃及非酒精性脂肪性肝病患者肝纤维化中的应用。

Serum TGF-β, Serum MMP-1, and HOMA-IR as non-invasive predictors of fibrosis in Egyptian patients with NAFLD.

机构信息

Department of Internal Medicine, Gastroenterology and Hepatology Unit, Ain-Shams University, Abbassia, Cairo, Egypt.

出版信息

Saudi J Gastroenterol. 2012 Sep-Oct;18(5):327-33. doi: 10.4103/1319-3767.101132.

Abstract

BACKGROUND/AIM: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent cause of chronic liver disease worldwide. A number of these patients progress to nonalcoholic steatohepatitis (NASH) which carries significant morbidity and mortality. The aim of this study is to evaluate the diagnostic value of serum levels of transforming growth factor beta-1 (TGF-β1) matrix metalloproteinase-1 (MMP-1), and insulin resistance as predictors of fibrosis in Egyptian NAFLD patients.

PATIENTS AND METHODS

Fifty patients with NAFLD and different stages of fibrosis were studied. Serum levels of TGF-β1, MMP-1, and fasting serum insulin were measured; calculation of the homeostasis model assessment for insulin resistance (HOMA-IR) was done.

RESULTS

TGF-β1 gives a sensitivity of 100% and specificity of 94.4% for stage 1 fibrosis, 100% and 93.9%, respectively, for stage 2 fibrosis, and 97.7% and 100%, respectively, for stage 3 fibrosis. MMP-1 showed sensitivity and specificity of 88% and 81.8%, respectively, for stage 2 fibrosis, 90.9% and 55.56%, respectively, for stage 3 fibrosis, but it is of no diagnostic value in stage 1 fibrosis.

CONCLUSION

Serum TGF-β1, MMP-1, and insulin resistance (HOMA-IR) proved to be potentially useful noninvasive markers in predicting fibrosis in NASH patients.

摘要

背景/目的:非酒精性脂肪性肝病(NAFLD)是全球范围内慢性肝病日益增多的原因。这些患者中有许多进展为非酒精性脂肪性肝炎(NASH),这会带来显著的发病率和死亡率。本研究旨在评估血清转化生长因子-β1(TGF-β1)、基质金属蛋白酶-1(MMP-1)和胰岛素抵抗水平作为埃及 NAFLD 患者纤维化预测因子的诊断价值。

患者与方法

研究了 50 例 NAFLD 患者和不同纤维化阶段的患者。测量了血清 TGF-β1、MMP-1 和空腹血清胰岛素水平;计算了胰岛素抵抗的稳态模型评估(HOMA-IR)。

结果

TGF-β1 对 1 期纤维化的敏感性为 100%,特异性为 94.4%;对 2 期纤维化的敏感性和特异性分别为 100%和 93.9%;对 3 期纤维化的敏感性和特异性分别为 97.7%和 100%。MMP-1 对 2 期纤维化的敏感性和特异性分别为 88%和 81.8%;对 3 期纤维化的敏感性和特异性分别为 90.9%和 55.56%;但对 1 期纤维化无诊断价值。

结论

血清 TGF-β1、MMP-1 和胰岛素抵抗(HOMA-IR)被证明是预测 NASH 患者纤维化的潜在有用的非侵入性标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1466/3500022/537206449b75/SJG-18-327-g003.jpg

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