Matsushita Noriko, Hashimoto Etsuko, Tokushige Katsutoshi, Kodama Kazuhisa, Tobari Maki, Kogiso Tomomi, Torii Nobuyuki, Taniai Makiko, Shiratori Keiko, Murayama Hiroshi
Department of Medicine and Gastroenterology, Tokyo Women's Medical University, Japan.
Intern Med. 2014;53(12):1249-57. doi: 10.2169/internalmedicine.53.1944. Epub 2014 Jun 15.
Ornithine carbamoyltransferase (OCT) is a liver-specific mitochondrial matrix enzyme and potential biomarker of liver fibrosis. This study investigated the OCT levels in patients with chronic liver disease with or without cirrhosis in order to assess the usefulness of OCT as a biomarker of cirrhosis.
The subjects included 440 Japanese patients with chronic liver disease and 80 control subjects. The patients were divided into two groups, those with and without cirrhosis, both of which were further stratified into high-OCT and low-OCT subgroups.
In the non-cirrhosis group, the patients with non-alcoholic steatohepatitis (NASH), alcoholic liver disease, primary biliary cirrhosis and primary sclerosing cholangitis (PSC) comprised the high-OCT subgroup, while the patients with hepatitis B, hepatitis C and autoimmune hepatitis formed the low-OCT subgroup. There were significant differences in the OCT levels, OCT/aspartate aminotransferase ratios and OCT/alanine transaminase (ALT) ratios between these two subgroups (p<0.001). The same findings were observed in the cirrhosis group. The OCT levels were markedly higher in the cirrhosis group than in the non-cirrhosis group, particularly among the patients with PSC (p<0.001). The most useful biomarker for predicting cirrhosis was the OCT/ALT ratio in the patients with hepatitis C and NASH and the OCT level in patients with PSC.
The OCT level differs among patients with different chronic liver diseases. The role of OCT should be further evaluated in order to improve our understanding of the pathogenesis of these diseases. The OCT level is a useful surrogate marker of cirrhosis, particularly in PSC patients.
鸟氨酸氨甲酰基转移酶（OCT）是一种肝脏特异性线粒体基质酶，也是肝纤维化的潜在生物标志物。本研究调查了伴有或不伴有肝硬化的慢性肝病患者的OCT水平，以评估OCT作为肝硬化生物标志物的实用性。
研究对象包括440名日本慢性肝病患者和80名对照者。患者被分为两组，即有肝硬化组和无肝硬化组，每组又进一步分为高OCT亚组和低OCT亚组。
在无肝硬化组中，非酒精性脂肪性肝炎（NASH）、酒精性肝病、原发性胆汁性肝硬化和原发性硬化性胆管炎（PSC）患者组成高OCT亚组，而乙型肝炎、丙型肝炎和自身免疫性肝炎患者组成低OCT亚组。这两个亚组之间的OCT水平、OCT/天冬氨酸转氨酶比值和OCT/丙氨酸转氨酶（ALT）比值存在显著差异（p<0.001）。在肝硬化组中也观察到了相同的结果。肝硬化组的OCT水平明显高于无肝硬化组，尤其是PSC患者（p<0.001）。预测肝硬化最有用的生物标志物是丙型肝炎和NASH患者的OCT/ALT比值以及PSC患者的OCT水平。
不同慢性肝病患者的OCT水平存在差异。应进一步评估OCT的作用，以增进我们对这些疾病发病机制的理解。OCT水平是肝硬化的一个有用替代标志物，尤其是在PSC患者中。
