Liver Center, The First Affiliated Hospital, Fujian Medical University, No. 20, Chazhong road, 350005 Taijiang, Fuzhou, Fujian, PR China.
Department of Pharmacy, The First Affiliated Hospital, Fujian Medical University, No. 20, Chazhong road, 350005 Taijiang, Fuzhou, Fujian, PR China.
Clin Res Hepatol Gastroenterol. 2020 Feb;44(1):57-65. doi: 10.1016/j.clinre.2019.04.001. Epub 2019 May 7.
To evaluate the significance of serum ceruloplasmin (CP) to diagnosis hepatic steatosis (HS) in Chronic hepatitis B (CHB) patients.
A total of 360 CHB patients with HS (n = 136) or without HS (n = 224) were included. Relationships between CP and HS degrees were analyzed by Spearman rank correlation. HS-predictive models including CP were constructed using multivariate logistic regression analysis and compared to other HS predicting indexes.
Serum CP were significantly higher in CHB patients with HS than in patients without HS (P < 0.001) and were positively correlated with HS degree (r = 0.487, P < 0.001). The area under the receiver-operating characteristic curves (AUCs) of using CP to predict HS (S ≥ 1), moderate and severe steatosis (S ≥ 2) and severe steatosis (S = 3) were 0.758, 0.794 and 0.883, respectively. Multivariate analysis showed that CP, age, high density lipoprotein (HDL) and hemoglobin were independent predictors of HS, and CP, body mass index and HDL were independent predictors of moderate and severe HS. Two novel indexes for predicting HS of CHB patients were generated. The AUC of HSCHB-1 (for S ≥ 1) and HSCHB-2 (for S ≥ 2) were 0.881 and 0.916 in the training group, and 0.865 and 0.841 in the validation group, respectively. HSCHB-1 was superior to HS index (P < 0.001), fatty liver disease index (P = 0.0043) and steatosis index of patients with hepatitis B virus infection (P = 0.0029) in predicting HS in CHB patients.
HS of CHB patients was positively associated with serum CP. HSCHB-1 and HSCHB-2 with inclusion of CP are two novel models for predicting HS in CHB patients.
评估血清铜蓝蛋白（CP）对慢性乙型肝炎（CHB）患者肝脂肪变性（HS）诊断的意义。
纳入 360 例 CHB 患者，其中 HS 组（n=136）和非 HS 组（n=224）。采用 Spearman 秩相关分析 CP 与 HS 程度的关系。采用多因素 logistic 回归分析建立包括 CP 的 HS 预测模型，并与其他 HS 预测指标进行比较。
CHB 患者 HS 组血清 CP 显著高于非 HS 组（P<0.001），且与 HS 程度呈正相关（r=0.487，P<0.001）。CP 预测 HS（S≥1）、中度和重度脂肪变性（S≥2）和重度脂肪变性（S=3）的受试者工作特征曲线下面积（AUC）分别为 0.758、0.794 和 0.883。多因素分析显示，CP、年龄、高密度脂蛋白（HDL）和血红蛋白是 HS 的独立预测因素，CP、体重指数和 HDL 是中重度 HS 的独立预测因素。建立了两种用于预测 CHB 患者 HS 的新指标。在训练组中，HSCHB-1（用于 S≥1）和 HSCHB-2（用于 S≥2）的 AUC 分别为 0.881 和 0.916，在验证组中分别为 0.865 和 0.841。HSCHB-1 在预测 CHB 患者 HS 方面优于 HS 指数（P<0.001）、脂肪性肝病指数（P=0.0043）和乙型肝炎病毒感染患者脂肪变性指数（P=0.0029）。
CHB 患者 HS 与血清 CP 呈正相关。纳入 CP 的 HSCHB-1 和 HSCHB-2 是两种用于预测 CHB 患者 HS 的新模型。
