Department of Gastroenterology, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.
Department of Endocrinology and Metabolism, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan.
J Gastroenterol Hepatol. 2019 Oct;34(10):1829-1835. doi: 10.1111/jgh.14654. Epub 2019 Apr 7.
Accurate diagnosis of non-alcoholic steatohepatitis (NASH) from non-alcoholic fatty liver disease (NAFLD) is clinically important. Therefore, there is a need for easier ways of diagnosing NASH. In this study, we investigated the serum fatty acid composition and evaluated the possibility of using the serum fatty acid composition as a diagnostic marker of NASH.
The subjects were 78 NAFLD patients (non-alcoholic fatty liver [NAFL]: 30, NASH: 48) and 24 healthy individuals. Fatty acids extracted from the liver tissue and serum were identified and quantified by gas chromatography. In addition, we evaluated the relationship between serum and liver tissue fatty acid composition, patient background, and liver histology. The diagnostic performance of NASH was evaluated by calculating the area under the receiver operating characteristic (AUROC).
The results of the fatty acid analysis showed the C16:1n7/C16:0 ratio to have the strongest correlation between serum and liver tissue (r = 0.865, P < 0.0001). The serum C16:1n7/C16:0 ratio in the NASH group was higher compared with that in the NAFL group (P = 0.0007). Evaluation of the association of the serum C16:1n7/C16:0 ratio with liver histology revealed significant correlation with lobular inflammation score, ballooning score, and fibrosis score. The AUROC for predicting NASH in all NAFLD patients was 0.7097. The AUROC was nearly equivalent even when the study subjects were restricted to patients with a fibrosis score ≤ 2 only (AUROC 0.6917).
Measuring the serum C16:1n7/C16:0 ratio may be an effective non-invasive method for diagnosing NASH, particularly in its early stages.
准确诊断非酒精性脂肪性肝炎（NASH）对于非酒精性脂肪性肝病（NAFLD）的临床诊断非常重要。因此，我们需要更简单的方法来诊断 NASH。在本研究中，我们研究了血清脂肪酸组成，并评估了血清脂肪酸组成作为 NASH 诊断标志物的可能性。
研究对象为 78 例 NAFLD 患者（非酒精性脂肪肝 [NAFL]：30 例，NASH：48 例）和 24 名健康对照者。采用气相色谱法对肝组织和血清中的脂肪酸进行鉴定和定量。此外，我们评估了血清和肝组织脂肪酸组成与患者背景和肝组织学之间的关系。通过计算受试者工作特征曲线（ROC）下面积（AUROC）评估 NASH 的诊断性能。
脂肪酸分析结果表明，血清和肝组织中 C16:1n7/C16:0 比值的相关性最强（r=0.865，P<0.0001）。NASH 组血清 C16:1n7/C16:0 比值高于 NAFL 组（P=0.0007）。评估血清 C16:1n7/C16:0 比值与肝组织学的相关性，发现其与小叶炎症评分、气球样变评分和纤维化评分均显著相关。在所有 NAFLD 患者中，预测 NASH 的 AUROC 为 0.7097。当研究对象仅限于纤维化评分≤2 的患者时，AUROC 几乎相同（AUROC 0.6917）。
检测血清 C16:1n7/C16:0 比值可能是一种有效的非侵入性方法，用于诊断 NASH，尤其是在疾病早期。
