Boga Salih, Koksal Ali Riza, Alkim Huseyin, Yilmaz Ozguven Muveddet Banu, Bayram Mehmet, Ergun Meltem, Sisman Gurhan, Tekin Neijmann Sebnem, Alkim Canan
1 Department of Gastroenterology, Sisli Hamidiye Etfal Education and Research Hospital , Istanbul, Turkey .
2 Department of Pathology, Sisli Hamidiye Etfal Education and Research Hospital , Istanbul, Turkey .
Metab Syndr Relat Disord. 2015 Nov;13(9):393-9. doi: 10.1089/met.2015.0046. Epub 2015 Sep 14.
Nonalcoholic fatty liver disease (NAFLD) includes a variety of histopathological findings ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which can only be differentiated by liver biopsy. There is yet no unique biomarker found to discriminate NASH from simple steatosis.We aimed to investigate the relationship of plasma pentraxin 3 (PTX3) and its main stimulant tumor necrosis factor alpha (TNF-α) with the degree of liver damage in NAFLD.
Plasma PTX3 and TNF-α levels were measured in 70 patients with histologically verified NAFLD (56 with NASH, 14 with non-NASH) and 12 controls.
PTX3 and TNF-α levels were found significantly higher in the NAFLD group than in the control group (4.1 ± 2.3 vs. 1.3 ± 0.8 ng/mL, P < 0.001, and 7.6 ± 4.1 vs. 3.3 ± 1.3 pg/mL, P < 0.001 respectively) and in biopsy proven NASH subgroup than non-NASH subgroup (4.6 ± 2.2 vs. 2.2 ± 1.7 ng/mL, P = 0.001, and 8.3 ± 4.3 vs. 4.6 ± 1.6 pg/mL, P = 0.001 respectively). To discriminate NASH from non-NASH PTX3 had 91.1% sensitivity and 71.4% specificity at the cutoff value of 2.45 ng/mL. Plasma PTX3 levels showed correlation with NAFLD activity score, fibrosis stage and steatosis grade (r = 0.659, P < 0.001; r = 0.354, P < 0.01; and r = 0.455, P < 0.001, respectively).
This study demonstrated markedly higher PTX3 levels in NAFLD patients compared with controls, and in biopsy proven NASH patients compared with non-NASH ones. Thus, in this cohort we showed that plasma PTX3 may be a promising biomarker for the presence of NASH.
非酒精性脂肪性肝病(NAFLD)包括从单纯性脂肪变性到非酒精性脂肪性肝炎(NASH)的多种组织病理学表现,而这只能通过肝活检来区分。目前尚未发现能够区分NASH与单纯性脂肪变性的独特生物标志物。我们旨在研究血浆五聚体3(PTX3)及其主要刺激物肿瘤坏死因子α(TNF-α)与NAFLD肝损伤程度之间的关系。
检测了70例经组织学证实的NAFLD患者(56例为NASH,14例为非NASH)和12例对照者的血浆PTX3和TNF-α水平。
发现NAFLD组的PTX3和TNF-α水平显著高于对照组(分别为4.1±2.3 vs. 1.3±0.8 ng/mL,P<0.001;以及7.6±4.1 vs. 3.3±1.3 pg/mL,P<0.001),且经活检证实的NASH亚组高于非NASH亚组(分别为4.6±2.2 vs. 2.2±1.7 ng/mL,P=0.001;以及8.3±4.3 vs. 4.6±1.6 pg/mL,P=0.001)。在截断值为2.45 ng/mL时,PTX3区分NASH与非NASH的敏感性为91.1%,特异性为7.4%。血浆PTX3水平与NAFLD活动评分、纤维化分期和脂肪变性分级相关(r分别为0.659,P<;0.001;r为0.354,P<;0.01;以及r为0.455,P<;0.001)。
本研究表明,与对照组相比,NAFLD患者的PTX3水平显著更高,与非NASH患者相比,经活检证实的NASH患者的PTX3水平显著更高。因此,在本队列研究中,我们表明血浆PTX3可能是NASH存在的一种有前景的生物标志物。