非酒精性脂肪性肝病的生物标志物。
Biomarkers in nonalcoholic fatty liver disease.
出版信息
Can J Gastroenterol Hepatol. 2014 Dec;28(11):607-18. doi: 10.1155/2014/757929.
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is a chronic liver condition characterized by insulin resistance, type 2 diabetes and fat accumulation in the liver that may cause hepatic inflammation and progressive scarring leading to nonalcoholic steatohepatitis (NASH) and irreversible liver damage (cirrhosis). As a result, there has been increased recognition of the need to assess and closely monitor individuals for risk factors of components of NAFLD and NASH, as well as the severity of these conditions using biomarkers.
AIM
To review the biomarkers used to diagnose and define the severity of NAFLD and NASH.
METHODS
A comprehensive PubMed and Google Scholar literature search was performed using the terms "non-alcoholic fatty liver disease", "non-alcoholic steatohepatitis", as well as the name of each biomarker known to be used. Articles indexed between 2004 and 2014 were used. Each author read the publications separately and the results were discussed.
RESULTS
Biomarkers offer a potential prognostic or diagnostic indicator for disease manifestation, progression or both. Serum biomarkers, including total cholesterol, triglycerides, insulin resistance and C-peptide, have been used for many years. Emerging biomarkers, such as apolipoprotein A1, apolipoprotein B, leptin, adiponectin, free fatty acids, ghrelin and tumour necrosis factor-alpha, have been proposed as tools that could provide valuable complementary information to that obtained from traditional biomarkers. Moreover, markers of cell death and mitochondrial dysfunction (cytokeratins) represent powerful predictors of risk. For biomarkers to be clinically useful in accurately diagnosing and treating disorders, age-specific reference intervals that account for differences in sex and ethnic origin are a necessity.
CONCLUSIONS
The present review attempts to provide a comprehensive analysis of the emerging risk biomarkers of NAFLD and NASH, and to use the clinical significance and analytical considerations of each biomarker pointing out sentinel features of disease progression.
背景
非酒精性脂肪性肝病（NAFLD）是一种慢性肝脏疾病，其特征为胰岛素抵抗、2 型糖尿病和肝脏脂肪堆积，可能导致肝脏炎症和进行性瘢痕形成，导致非酒精性脂肪性肝炎（NASH）和不可逆转的肝损伤（肝硬化）。因此，人们越来越认识到需要评估和密切监测个体的非酒精性脂肪性肝病和 NASH 的危险因素以及这些疾病的严重程度，使用生物标志物。
目的
综述用于诊断和定义非酒精性脂肪性肝病和 NASH 严重程度的生物标志物。
方法
使用“非酒精性脂肪性肝病”、“非酒精性脂肪性肝炎”以及已知用于诊断的每种生物标志物的名称等术语，对 PubMed 和 Google Scholar 进行了全面的文献检索。使用 2004 年至 2014 年索引的文章。每位作者分别阅读出版物，讨论结果。
结果
生物标志物为疾病表现、进展或两者都提供了潜在的预后或诊断指标。血清生物标志物，包括总胆固醇、甘油三酯、胰岛素抵抗和 C 肽，多年来一直被用于临床。新兴的生物标志物，如载脂蛋白 A1、载脂蛋白 B、瘦素、脂联素、游离脂肪酸、ghrelin 和肿瘤坏死因子-α，被提议作为可以提供比传统生物标志物更有价值的补充信息的工具。此外，细胞死亡和线粒体功能障碍的标志物（细胞角蛋白）是风险的有力预测指标。为了使生物标志物在准确诊断和治疗疾病方面具有临床意义，需要有年龄特异性的参考区间，以说明性别和种族差异。
结论
本综述试图对非酒精性脂肪性肝病和 NASH 的新兴风险生物标志物进行全面分析，并利用每个生物标志物的临床意义和分析注意事项，指出疾病进展的哨兵特征。
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