胆汁酸谱在诊断和分期酒精性肝病中的作用。

Efficacy of bile acid profiles in diagnosing and staging of alcoholic liver disease.

机构信息

Clinical Laboratory, The First Hospital of Jilin University, Changchun, China.

出版信息

Scand J Clin Lab Invest. 2023 Feb;83(1):8-17. doi: 10.1080/00365513.2022.2151508. Epub 2022 Dec 9.

DOI:10.1080/00365513.2022.2151508

PMID:36484775

Abstract

AIM

The diagnosis of alcoholic liver disease (ALD) is still a great challenge. Therefore, the purpose of this study is to identify and characterize new metabolomic biomarkers for the diagnosis and staging of ALD.

METHODS

A total of 127 patients with early liver injury, 40 patients with alcoholic cirrhosis (ALC) and 40 healthy controls were included in this study. Patients with early liver injury included 45 patients with alcoholic liver disease (ALD), 40 patients with non-alcoholic fatty liver disease (NAFLD) and 40 patients with viral liver disease (VLD). The differential metabolites in serum samples were analyzed using ultra-high-performance liquid chromatography-quadrupole/time-of-flight mass spectrometry, and partial metabolites in the differential metabolic pathway were identified by liquid chromatography- tandem mass spectrometry.

RESULTS

A total of 40 differential metabolites and five differential metabolic pathways in the four groups of patients with early liver disease and healthy controls were found, and the metabolic pathway of primary bile acid (BA) biosynthesis was the pathway that included the most differential metabolites. Therefore, 22 BA profiles were detected. The results revealed that the changes of BA profiles were most pronounced in patients with ALD compared with patients with NAFLD and VLD, in whom 12 differential BAs were diagnostic markers of ALD (AUC = 0.883). The 19 differential BAs in ALC and ALD were diagnostic markers of the stage of alcoholic hepatic fibrosis (AUC = 0.868).

CONCLUSION

BA profiles are potential indicators in the diagnosis of ALD and evaluation of different stages.

摘要

目的

酒精性肝病（ALD）的诊断仍然是一个巨大的挑战。因此，本研究的目的是确定和表征新的代谢组学生物标志物，用于 ALD 的诊断和分期。

方法

本研究共纳入 127 例早期肝损伤患者、40 例酒精性肝硬化（ALC）患者和 40 例健康对照者。早期肝损伤患者包括 45 例酒精性肝病（ALD）患者、40 例非酒精性脂肪性肝病（NAFLD）患者和 40 例病毒性肝病（VLD）患者。采用超高效液相色谱-四极杆/飞行时间质谱分析血清样本中的差异代谢物，并通过液相色谱-串联质谱鉴定差异代谢途径中的部分代谢物。

结果

在早期肝病患者和健康对照者的四组患者中，共发现 40 种差异代谢物和 5 条差异代谢途径，初级胆汁酸（BA）生物合成代谢途径包含的差异代谢物最多。因此，检测到 22 种 BA 谱。结果显示，与 NAFLD 和 VLD 患者相比，ALD 患者的 BA 谱变化最为明显，其中 12 种差异 BA 是 ALD 的诊断标志物（AUC=0.883）。ALC 和 ALD 中的 19 种差异 BA 是酒精性肝纤维化分期的诊断标志物（AUC=0.868）。