Ikeda Hitoshi, Kobayashi Mariko, Kumada Hiromitsu, Enooku Kenichiro, Koike Kazuhiko, Kurano Makoto, Sato Masaya, Nojiri Takahiro, Kobayashi Tamaki, Ohkawa Ryunosuke, Shimamoto Satoshi, Igarashi Koji, Aoki Junken, Yatomi Yutaka
1 Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
2 Department of Hepatology, Toranomon Hospital, Minato-ku, Tokyo, Japan.
Ann Clin Biochem. 2018 Jul;55(4):469-477. doi: 10.1177/0004563217741509. Epub 2017 Nov 13.
Background Because autotaxin reportedly has a better performance than hyaluronic acid as a marker for liver fibrosis for the prediction of cirrhosis caused by hepatitis C, we aimed to further evaluate the role of autotaxin in liver fibrosis of other aetiologies. Methods Autotaxin antigen was measured in serum samples from 108 patients with chronic hepatitis B and 128 patients with non-alcoholic fatty liver disease who had undergone a liver biopsy as well as healthy subjects and patients with chronic kidney disease, diabetes mellitus, rheumatoid arthritis and cardiac dysfunction. Results When evaluated using receiver operator characteristics curves, the performance of autotaxin for the prediction of significant fibrosis (F2-F4) in chronic hepatitis B patients was better than that of hyaluronic acid or type IV collagen 7S. In non-alcoholic fatty liver disease patients, however, the performance of autotaxin for the prediction of significant fibrosis was poorer than that of hyaluronic acid or type IV collagen 7S. The increase in the serum autotaxin concentrations was less notable than that of hyaluronic acid or type IV collagen in patients with chronic kidney disease, diabetes mellitus, rheumatoid arthritis or cardiac dysfunction. Food intake did not affect the serum autotaxin concentrations. Conclusions Autotaxin is useful as a serum marker for liver fibrosis caused by not only chronic viral hepatitis C but also by hepatitis B, although it was less useful in patients with non-alcoholic fatty liver disease. The increase in serum autotaxin concentrations is fairly specific for liver fibrosis, and the serum autotaxin concentrations can be analysed without consideration of food intake before blood collection.
背景 据报道，作为肝纤维化标志物，自分泌运动因子在预测丙型肝炎所致肝硬化方面比透明质酸表现更佳，我们旨在进一步评估自分泌运动因子在其他病因所致肝纤维化中的作用。方法 检测了108例慢性乙型肝炎患者、128例非酒精性脂肪性肝病患者（均接受了肝活检）以及健康受试者、慢性肾脏病患者、糖尿病患者、类风湿关节炎患者和心脏功能不全患者血清样本中的自分泌运动因子抗原。结果 使用受试者工作特征曲线进行评估时，自分泌运动因子预测慢性乙型肝炎患者显著纤维化（F2-F4）的性能优于透明质酸或IV型胶原7S。然而，在非酒精性脂肪性肝病患者中，自分泌运动因子预测显著纤维化的性能不如透明质酸或IV型胶原7S。慢性肾脏病、糖尿病、类风湿关节炎或心脏功能不全患者血清自分泌运动因子浓度的升高不如透明质酸或IV型胶原明显。食物摄入不影响血清自分泌运动因子浓度。结论 自分泌运动因子不仅可作为慢性丙型病毒性肝炎所致肝纤维化的血清标志物，也可用于慢性乙型肝炎所致肝纤维化，尽管在非酒精性脂肪性肝病患者中其作用较小。血清自分泌运动因子浓度的升高对肝纤维化具有较高的特异性，且分析血清自分泌运动因子浓度时无需考虑采血前的食物摄入情况。
