一种包含 AKR1B10 和细胞角蛋白 18 的复合血液生物标志物，用于诊断非酒精性脂肪性肝病的进展类型。
A Composite Blood Biomarker Including AKR1B10 and Cytokeratin 18 for Progressive Types of Nonalcoholic Fatty Liver Disease.
机构信息
Department of Radiology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of Family Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
出版信息
Diabetes Metab J. 2024 Jul;48(4):740-751. doi: 10.4093/dmj.2023.0189. Epub 2024 Feb 1.
BACKGRUOUND
We aimed to evaluate whether composite blood biomarkers including aldo-keto reductase family 1 member B10 (AKR1B10) and cytokeratin 18 (CK-18; a nonalcoholic steatohepatitis [NASH] marker) have clinically applicable performance for the diagnosis of NASH, advanced liver fibrosis, and high-risk NASH (NASH+significant fibrosis).
METHODS
A total of 116 subjects including healthy control subjects and patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) were analyzed to assess composite blood-based and imaging-based biomarkers either singly or in combination.
RESULTS
A composite blood biomarker comprised of AKR1B10, CK-18, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) showed excellent performance for the diagnosis of, NASH, advanced fibrosis, and high-risk NASH, with area under the receiver operating characteristic curve values of 0.934 (95% confidence interval [CI], 0.888 to 0.981), 0.902 (95% CI, 0.832 to 0.971), and 0.918 (95% CI, 0.862 to 0.974), respectively. However, the performance of this blood composite biomarker was inferior to that various magnetic resonance (MR)-based composite biomarkers, such as proton density fat fraction/MR elastography- liver stiffness measurement (MRE-LSM)/ALT/AST for NASH, MRE-LSM+fibrosis-4 index for advanced fibrosis, and the known MR imaging-AST (MAST) score for high-risk NASH.
CONCLUSION
Our blood composite biomarker can be useful to distinguish progressive forms of NAFLD as an initial noninvasive test when MR-based tools are not available.
背景
我们旨在评估包括醛酮还原酶家族 1 成员 B10（AKR1B10）和细胞角蛋白 18（CK-18；非酒精性脂肪性肝炎[NASH]标志物）在内的复合血液生物标志物是否具有临床适用的性能，用于诊断 NASH、晚期肝纤维化和高危 NASH（NASH+显著纤维化）。
方法
共分析了 116 例受试者，包括健康对照者和经活检证实的非酒精性脂肪性肝病（NAFLD）患者，以评估单一或联合使用基于血液和基于成像的复合生物标志物。
结果
由 AKR1B10、CK-18、天冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）组成的复合血液生物标志物在诊断 NASH、晚期纤维化和高危 NASH 方面表现出优异的性能，其受试者工作特征曲线下面积值分别为 0.934（95%置信区间[CI]，0.888 至 0.981）、0.902（95%CI，0.832 至 0.971）和 0.918（95%CI，0.862 至 0.974）。然而，这种血液复合生物标志物的性能不如各种基于磁共振（MR）的复合生物标志物，如质子密度脂肪分数/MR 弹性成像-肝硬度测量（MRE-LSM）/ALT/AST 用于 NASH、MRE-LSM+纤维化-4 指数用于晚期纤维化以及已知的 MR 成像-AST（MAST）评分用于高危 NASH。
结论
当无法使用基于 MR 的工具时，我们的血液复合生物标志物可以作为一种初始的非侵入性检测手段，用于区分进展性形式的 NAFLD。
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