血清β-促甲状腺素水平作为非酒精性脂肪性肝病和肝纤维化无创评估的新标志物。
Serum β-trophin level as a new marker for noninvasive assessment of nonalcoholic fatty liver disease and liver fibrosis.
作者信息
Cengiz Mustafa, Ozenirler Seren, Kocabiyik Murat
机构信息
aDepartment of Gastroenterology, Dr. A.Y. Ankara Oncology Training and Research Hospital bDepartment of Gastroenterology cDepartment of Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey.
出版信息
Eur J Gastroenterol Hepatol. 2016 Jan;28(1):57-63. doi: 10.1097/MEG.0000000000000502.
OBJECTIVE
Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease and evaluation of fibrosis is important. We aimed to investigate the utility of serum β-trophin in NAFLD and its ability to predict liver fibrosis.
PATIENTS AND METHODS
Serum samples of consecutive patients with biopsy-proven NAFLD and age-matched and sex-matched healthy controls were used to measure β-trophin using ELISA. Correlations between histopathological features of NAFLD and β-trophin were analyzed. Whereas patients with fibrosis scores less than 2 were grouped in the mild fibrosis group, patients with scores of 2 or more were grouped in the significant fibrosis group. Univariate/multivariate logistic regression analyses were carried out to evaluate the independent predicting factors of liver fibrosis. Receiver operating characteristics (ROCs) were assessed to determine the best cut-off values for NAFLD and fibrosis.
RESULTS
Sixty-nine patients with NAFLD and 69 healthy controls were enrolled in the study. Serum β-trophin levels were lower in NAFLD patients compared with the controls (2.34±0.06 vs. 1.94±0.09 ng/ml, respectively, P<0.001). In NAFLD, serum β-trophin was related to liver fibrosis and inflammation. The mild fibrosis group had higher serum β-trophin levels than the significant fibrosis group (2.11±0.12 vs. 1.72±0.11, respectively, P<0.001). In multivariate analysis, β-trophin remained an independent predictor of significant fibrosis (odds ratio, 0.237; 95% confidence interval, 0.059-0.949; P<0.001). ROC analysis showed that serum β-trophin was statistically significant in the identification of significant fibrosis (area under receiver operating characteristic, 0.844; 95% confidence interval, 0.718-0.970; P<0.001). The best cut-off value was 1.786, with the best sensitivity (71.43%) and specificity (95.65%).
CONCLUSION
Serum β-trophin may be a potential noninvasive marker for the identification of NAFLD and significant liver fibrosis.
目的
非酒精性脂肪性肝病（NAFLD）是一种常见的慢性肝病，纤维化评估至关重要。我们旨在研究血清β-促甲状腺素在NAFLD中的作用及其预测肝纤维化的能力。
患者与方法
使用酶联免疫吸附测定法（ELISA）对经活检证实为NAFLD的连续患者以及年龄和性别匹配的健康对照者的血清样本进行β-促甲状腺素检测。分析NAFLD的组织病理学特征与β-促甲状腺素之间的相关性。纤维化评分小于2的患者被归为轻度纤维化组，评分2及以上的患者被归为显著纤维化组。进行单因素/多因素逻辑回归分析以评估肝纤维化的独立预测因素。评估受试者工作特征（ROC）曲线以确定NAFLD和纤维化的最佳临界值。
结果
69例NAFLD患者和69例健康对照者纳入本研究。NAFLD患者的血清β-促甲状腺素水平低于对照组（分别为2.34±0.06与1.94±0.09 ng/ml，P<0.001）。在NAFLD中，血清β-促甲状腺素与肝纤维化和炎症相关。轻度纤维化组的血清β-促甲状腺素水平高于显著纤维化组（分别为2.11±0.12与1.72±0.11，P<0.001）。在多因素分析中，β-促甲状腺素仍然是显著纤维化的独立预测因子（比值比，0.237；95%置信区间，0.059 - 0.949；P<0.001）。ROC分析表明，血清β-促甲状腺素在识别显著纤维化方面具有统计学意义（受试者工作特征曲线下面积，0.844；95%置信区间，0.718 - 0.970；P<0.001）。最佳临界值为1.786，具有最佳敏感性（71.43%）和特异性（95.65%）。
结论
血清β-促甲状腺素可能是识别NAFLD和显著肝纤维化的潜在非侵入性标志物。
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