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五聚体蛋白3作为老年人代谢功能障碍相关脂肪性肝病中纤维化的不良标志物:PolSenior2子研究的结果

Pentraxin-3 as a poor marker of fibrosis in metabolic dysfunction-associated steatotic liver disease among older adults: findings from the PolSenior2 substudy.

作者信息

Owczarek Aleksander Jerzy, Musialik Joanna, Stefański Adrian, Mossakowska Małgorzata, Zięba Katarzyna, Więcek Andrzej, Chudek Jerzy, Olszanecka-Glinianowicz Magdalena

机构信息

Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland.

Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland.

出版信息

Front Med (Lausanne). 2025 Feb 24;12:1445973. doi: 10.3389/fmed.2025.1445973. eCollection 2025.

Abstract

INTRODUCTION

The study aimed to assess the relationship between plasma pentraxin 3 (PTX-3) levels and the potential diagnosis of fibrosis in metabolic dysfunction-associated steatohepatitis (MASH) in older adults. This was assessed using the Fibrosis-4 index (FIB-4), NAFLD fibrosis score (NFS), and Hepamet fibrosis score (HFS).

MATERIALS AND METHODS

The subanalysis included 2,397 older adults (aged 60 years and older) from the population-based PolSenior2 study, all of whom had risk factors for metabolic dysfunction-associated steatotic liver disease (MASLD) and underwent PTX-3 assessment. The participants were divided into two subgroups according to the FIB-4 values (≤2.67 and > 2.67), three subgroups according to the NFS values (< -1.455, -1.455, and 0.675, and > 0.675), and three subgroups according to the HFS values (< 0.12, 0.12 and 0.47 and > 0.47).

RESULTS

The empirical cutoff points for PTX-3 levels as a potential marker of liver fibrosis were assessed separately for women and men. In women, the cutoff points for PTX-3 levels based on ROC curve analyses ranged from 1.96 to 2.30 ng/mL (an AUC ranging from 0.596 to 0.643, sensitivity between 39.1 and 61.7%, and specificity between 56.1 and 79.6%). In men, a significant cutoff point was established for FIB-4 (an AUC of 0.549, sensitivity of 39.4%, and specificity of 69.6%). Overall, the accuracy was poor.

CONCLUSION

Our study suggests that plasma PTX-3 levels are not sensitive enough to be used as a non-specific marker of liver fibrosis in older adults.

摘要

引言

本研究旨在评估老年人群中血浆五聚体3(PTX-3)水平与代谢功能障碍相关脂肪性肝炎(MASH)纤维化潜在诊断之间的关系。使用纤维化-4指数(FIB-4)、非酒精性脂肪性肝病纤维化评分(NFS)和肝纤维化评分(HFS)进行评估。

材料与方法

该亚分析纳入了基于人群的PolSenior2研究中的2397名老年人(年龄≥60岁),他们均有代谢功能障碍相关脂肪性肝病(MASLD)的危险因素并接受了PTX-3评估。参与者根据FIB-4值(≤2.67和>2.67)分为两个亚组,根据NFS值(<-1.455、-1.455至0.675和>0.675)分为三个亚组,根据HFS值(<0.12、0.12至0.47和>0.47)分为三个亚组。

结果

分别评估了女性和男性PTX-3水平作为肝纤维化潜在标志物的经验性截断点。在女性中,基于ROC曲线分析的PTX-3水平截断点范围为1.96至2.30 ng/mL(AUC范围为0.596至0.643,敏感性在39.1%至61.7%之间,特异性在56.1%至79.6%之间)。在男性中,为FIB-4确定了一个显著的截断点(AUC为0.549,敏感性为39.4%,特异性为69.6%)。总体而言,准确性较差。

结论

我们的研究表明,血浆PTX-3水平不够敏感,不能用作老年人肝纤维化的非特异性标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1e2/11891235/9fcadaac748a/fmed-12-1445973-g001.jpg

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