Mykhalchyshyn Galyna, Kobyliak Nazarii, Bodnar Petro
Bogomolets National Medical University, T. Shevchenko blvd, 13, 01601 Kyiv, Ukraine.
J Diabetes Metab Disord. 2015 May 19;14:44. doi: 10.1186/s40200-015-0170-1. eCollection 2015.
Ghrelin is a hormone produced mainly by the cells lining the fundus of the stomach, which is involved in regulation of lipid and glucose metabolism. Two major forms of ghrelin can be found in circulation: an acylated form, and non-acylated form. Serum acyl-ghrelin (AG) concentration is significantly increased in patients with visceral obesity and insulin resistance. This study was conducted to evaluate changes in serum AG levels, its diagnostic accuracy and association with NAFLD in patients with type two diabetes (T2D).
In this cross-sectional study, 91 T2D patients, age of 40-80 years, were included. All patients were divided into 3 groups. The control group included 28 T2D patients without NAFLD. The main group included 63 T2D patients with NAFLD, which was divided in 2 subgroups depending on transaminase levels: normal (n = 37) and elevated (n = 26) transaminases group. To assess the diagnostic accuracy of AG for NAFLD we used ROC-analysis.
We observed 1.5 (p = 0.016) and 2.5 (p < 0.001) fold increasing of serum AG levels in patients with NAFLD and normal or elevated transaminases compared to control groups. In multivariate logistic regression analysis high AG level was an independent, from transaminases activity, triglycerides (OR 1.791; 95 % CI 1.162-2.759; p = 0.008) and degree of IR (OR 1.599; 95 % CI 1.019-2.508; p = 0.044) predictor that associated with NAFLD. When serum AG used as non-invasive marker for NAFLD detection AUROC was 0.835 (95 % CI 0.752-0.918, p < 0.001). The cut-off value was >0.52 ng/ml, with sensitivity, specificity, PPV and NPV - 60.3 %, 92.8 %, 95.0 %, 50.9 % respectively. For distinguishing patients with NAFLD and elevated transaminases from patients with NAFLD and normal values AG was less effective.
Our study has demonstrated that elevated AG level were associated with NAFLD. Patients with elevated transaminases had significantly higher AG levels. An increase of AG over 0.52 ng/ml can be used as a diagnostic marker for NAFLD detection in patients with T2D.
胃饥饿素是一种主要由胃底内衬细胞产生的激素，参与脂质和葡萄糖代谢的调节。循环中可发现两种主要形式的胃饥饿素：酰化形式和非酰化形式。内脏肥胖和胰岛素抵抗患者的血清酰化胃饥饿素（AG）浓度显著升高。本研究旨在评估2型糖尿病（T2D）患者血清AG水平的变化、其诊断准确性以及与非酒精性脂肪性肝病（NAFLD）的关联。
在这项横断面研究中，纳入了91名年龄在40 - 80岁的T2D患者。所有患者分为3组。对照组包括28名无NAFLD的T2D患者。主要组包括63名患有NAFLD的T2D患者，根据转氨酶水平分为2个亚组：转氨酶正常（n = 37）和转氨酶升高（n = 26）组。为评估AG对NAFLD的诊断准确性，我们使用了ROC分析。
我们观察到，与对照组相比，NAFLD患者以及转氨酶正常或升高的患者血清AG水平分别升高了1.5倍（p = 0.016）和2.5倍（p < 0.001）。在多因素逻辑回归分析中，高AG水平是一个独立于转氨酶活性、甘油三酯（OR 1.791；95% CI 1.162 - 2.759；p = 0.008）和胰岛素抵抗程度（OR 1.599；95% CI 1.019 - 2.508；p = 0.044）的预测指标，与NAFLD相关。当将血清AG用作NAFLD检测的非侵入性标志物时，曲线下面积（AUROC）为0.835（95% CI 0.752 - 0.918，p <
