Ge Penglei, Yang Huayu, Lu Jingfen, Liao Wenjun, Du Shunda, Xu Yingli, Xu Haifeng, Zhao Haitao, Lu Xin, Sang Xinting, Zhong Shouxian, Huang Jiefu, Mao Yilei
Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences and PUMC, Beijing, China.
State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China.
Gastroenterol Res Pract. 2016;2016:5120760. doi: 10.1155/2016/5120760. Epub 2016 Dec 22.
. Currently there is no indicator that can evaluate actual liver lesion for early stages of viral hepatitis, nonalcoholic fatty liver disease (NAFLD), and cirrhosis. Aim of this study was to investigate if albumin binding function could better reflect liver function in these liver diseases. . An observational study was performed on 193 patients with early NAFLD, viral hepatitis, and cirrhosis. Cirrhosis patients were separated according to Child-Pugh score into A, B, and C subgroup. Albumin metal ion binding capacity (Ischemia-modified albumin transformed, IMAT) and fatty acid binding capacity (total binding sites, TBS) were detected. . Both IMAT and TBS were significantly decreased in patients with NAFLD and early hepatitis. In hepatitis group, they declined prior to changes of liver enzymes. IMAT was significantly higher in cirrhosis Child-Pugh class A group than hepatitis patients and decreased in Child-Pugh class B and class C patients. Both IMAT/albumin and TBS/albumin decreased significantly in hepatitis and NAFLD group patients. . This is the first study to discover changes of albumin metal ion and fatty acid binding capacities prior to conventional biomarkers for liver damage in early stage of liver diseases. They may become potential earliest sensitive indicators for liver function evaluation.
目前,尚无指标可用于评估病毒性肝炎、非酒精性脂肪性肝病(NAFLD)和肝硬化早期的实际肝脏病变情况。本研究旨在探讨白蛋白结合功能是否能更好地反映这些肝脏疾病中的肝功能。
对193例早期NAFLD、病毒性肝炎和肝硬化患者进行了一项观察性研究。肝硬化患者根据Child-Pugh评分分为A、B和C亚组。检测白蛋白金属离子结合能力(缺血修饰白蛋白转化,IMAT)和脂肪酸结合能力(总结合位点,TBS)。
NAFLD患者和早期肝炎患者的IMAT和TBS均显著降低。在肝炎组中,它们在肝酶变化之前就有所下降。肝硬化Child-Pugh A级组的IMAT显著高于肝炎患者,而在Child-Pugh B级和C级患者中则降低。肝炎组和NAFLD组患者的IMAT/白蛋白和TBS/白蛋白均显著降低。
这是第一项发现肝脏疾病早期肝脏损伤的传统生物标志物之前白蛋白金属离子和脂肪酸结合能力变化的研究。它们可能成为肝功能评估最早的潜在敏感指标。