Liao Yi-Chun, Wu Juei-Seng, Chou Hsuan-Wen, Kuo Hsin-Yu, Lee Chun-Te, Wu Hung-Tsung, Li Chung-Hao, Ou Horng-Yih
Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 703, Taiwan.
J Clin Med. 2023 Apr 6;12(7):2741. doi: 10.3390/jcm12072741.
Since non-alcoholic fatty liver disease (NAFLD) is highly associated with obesity, cardiovascular disease, and diabetes, biomarkers for the diagnosis of NAFLD have become an important issue. Although cardiotrophin-1 (CT-1) has a protective effect on the liver in NAFLD animal models, the serum levels of CT-1 in human subjects with NAFLD were still unknown.
The present study aimed to investigate the relationship between the circulating concentration of CT-1 and the severity of hepatic steatosis graded by the value of the controlled attenuation parameter (CAP) in humans.
The study was designed as a cross-sectional study, and a total of 182 subjects were enrolled. Hepatic steatosis measurement was carried out with a Firoscan device and recorded by CAP. The enrolled study subjects were categorized into CAP < 238 dB/m, 238 ≤ CAP ≤ 259 dB/m, 260 ≤ CAP ≤ 290 dB/m, and CAP > 290 dB/m. Serum CT-1 concentrations were determined by enzyme-linked immunosorbent assay. The association between the serum CT-1 concentration and NAFLD was examined by multivariate linear regression analysis.
Body mass index, percentage of body fat, systolic and diastolic blood pressure, alanine aminotransferase (ALT), cholesterol, triglyceride, hemoglobin A1c and homeostatic model assessment for insulin resistance (HOMA-IR) were significantly increased in groups with higher CAP value, whereas high-density lipoprotein cholesterol was significantly decreased. In addition, serum CT-1 concentrations were significantly decreased in subjects with higher CAP values. In multivariate linear regression models, including age, sex, body fat percentage, CAP, high sensitivity- C reactive protein, uric acid, creatinine, ALT, total cholesterol, and HOMA-IR, only age, CAP and uric acid independently associated with CT-1 levels. Moreover, having NAFLD was independently associated with CT-1 after adjustment for sex, obesity and type 2 diabetes.
Serum CT-1 concentrations are decreased in subjects with NAFLD and negatively associated with CAP.
由于非酒精性脂肪性肝病（NAFLD）与肥胖、心血管疾病和糖尿病高度相关，用于诊断NAFLD的生物标志物已成为一个重要问题。尽管心肌营养素-1（CT-1）在NAFLD动物模型中对肝脏具有保护作用，但NAFLD患者血清中CT-1的水平仍不清楚。
本研究旨在探讨人类循环中CT-1浓度与通过受控衰减参数（CAP）值分级的肝脂肪变性严重程度之间的关系。
本研究设计为横断面研究，共纳入182名受试者。使用Firoscan设备进行肝脂肪变性测量，并通过CAP记录。将纳入的研究对象分为CAP<238 dB/m、238≤CAP≤259 dB/m、260≤CAP≤290 dB/m和CAP>290 dB/m。采用酶联免疫吸附测定法测定血清CT-1浓度。通过多变量线性回归分析检验血清CT-1浓度与NAFLD之间的关联。
CAP值较高的组中，体重指数、体脂百分比、收缩压和舒张压、丙氨酸转氨酶（ALT）、胆固醇、甘油三酯、糖化血红蛋白和胰岛素抵抗稳态模型评估（HOMA-IR）显著升高，而高密度脂蛋白胆固醇显著降低。此外，CAP值较高的受试者血清CT-1浓度显著降低。在多变量线性回归模型中，包括年龄、性别、体脂百分比、CAP、高敏C反应蛋白、尿酸、肌酐、ALT、总胆固醇和HOMA-IR，只有年龄、CAP和尿酸与CT-1水平独立相关。此外，在调整性别、肥胖和2型糖尿病后，患有NAFLD与CT-1独立相关。
NAFLD患者血清CT-1浓度降低，且与CAP呈负相关。
