白细胞介素-2 受体α作为非酒精性脂肪性肝病诊断的生物标志物。

Interleukin-2 receptor alpha as a biomarker for nonalcoholic fatty liver disease diagnosis.

机构信息

Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2021 Mar 1;84(3):261-266. doi: 10.1097/JCMA.0000000000000469.

DOI:10.1097/JCMA.0000000000000469

PMID:33306598

Abstract

BACKGROUND

Two recent studies in the adult and pediatric Nonalcoholic Steatohepatitis-Clinical Research Network (NASH-CRN) cohorts have shown that soluble interleukin-2 receptor alpha (IL2RA) levels increased with fibrosis severity. However, no hepatic study has been conducted in Asian morbidly obese patients who underwent bariatric surgery. In this study, we proposed IL2RA as a biomarker for nonalcoholic fatty liver disease (NAFLD) diagnosis and performed immunohistochemistry (IHC) staining of IL2RA.

METHODS

This prospective cohort study enrolled 123 morbidly obese patients who underwent bariatric surgery at Taipei Medical University Hospital from October 2016 to June 2018. During bariatric surgery, all patients underwent a wedge liver biopsy under laparoscopic guidance. The diagnoses of NASH and liver fibrosis were made histologically. In IHC of IL2RA, the number of lymphocytes with IL2RA immunoreactivity was counted in five high-power fields (×400, total: 1.19 mm2).

RESULTS

Among the 123 patients, the mean age was 35.5 years, mean body mass index (BMI) was 40.6 kg/m2, 87 (70.7%) were female, 25 (20.7%) had diabetes mellitus, and 57 (46.3%; 11 with non-NAFLD and 46 with steatosis) and 66 (53.7%) were included in the non-NASH and NASH groups, respectively. The NASH group had higher IHC of IL2RA than the non-NASH group. In multivariate analysis, IHC of IL2RA (odds ratio, 1.025; 95% confidence interval, 1.006-1.045; p = 0.011) and alanine aminotransferase (ALT; odds ratio, 1.045; 95% confidence interval, 1.018-1.073; p = 0.001) were the independent factors associated with NASH. The area under the receiver operating curve of IL2RA IHC for NASH was 0.627 at the cutoff value of 82 (p = 0.0113).

CONCLUSION

IL2RA is significantly associated with NASH in morbidly obese patients and would be a useful biomarker for NASH diagnosis.

摘要

背景

最近两项在成人和儿科非酒精性脂肪性肝炎临床研究网络（NASH-CRN）队列中的研究表明，可溶性白细胞介素 2 受体α（IL2RA）水平随纤维化严重程度而增加。然而，在接受减重手术的亚洲病态肥胖患者中，尚未进行肝脏研究。在这项研究中，我们提出 IL2RA 作为非酒精性脂肪性肝病（NAFLD）诊断的生物标志物，并进行了 IL2RA 的免疫组织化学（IHC）染色。

方法

本前瞻性队列研究纳入了 2016 年 10 月至 2018 年 6 月期间在台北医学大学附属医院接受减重手术的 123 名病态肥胖患者。在减重手术过程中，所有患者均在腹腔镜引导下进行楔形肝活检。通过组织学诊断 NASH 和肝纤维化。在 IL2RA 的 IHC 中，在五个高倍视野（×400，总计：1.19mm2）中计算具有 IL2RA 免疫反应性的淋巴细胞数量。

结果

在 123 名患者中，平均年龄为 35.5 岁，平均体重指数（BMI）为 40.6kg/m2，87 名（70.7%）为女性，25 名（20.7%）患有糖尿病，57 名（46.3%；11 名非非 NAFLD 和 46 名脂肪变性）和 66 名（53.7%）分别纳入非 NASH 和 NASH 组。NASH 组的 IL2RA IHC 高于非 NASH 组。多变量分析显示，IL2RA IHC（比值比，1.025；95%置信区间，1.006-1.045；p=0.011）和丙氨酸氨基转移酶（ALT；比值比，1.045；95%置信区间，1.018-1.073；p=0.001）是与 NASH 相关的独立因素。IL2RA IHC 对 NASH 的受试者工作特征曲线下面积为 0.627，截断值为 82（p=0.0113）。