血小板衍生生长因子受体-β作为埃及代谢相关脂肪性肝病糖尿病患者肝纤维化预测的无创生物标志物
Platelet-derived growth factor receptor-β as a non-invasive biomarker for liver fibrosis prediction in Egyptian diabetic patients with metabolic-associated fatty liver disease.
作者信息
Badran Hanaa, Elsabaawy Maha, Magdy Mai, Omar Hazem, Hendy Olfat, Awaad Eman, Al-Khalifa Maymona Abd El-Wahed, Abozeid Mai
机构信息
Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, 32511, Egypt.
Diagnostic and Interventional Radiology and Medical Imaging Department, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt.
出版信息
BMC Gastroenterol. 2025 Jul 17;25(1):524. doi: 10.1186/s12876-024-03542-y.
BACKGROUND
Circulating platelet-derived growth factor receptor-β (PDGFRβ) has recently been found to correlate with severity of liver disease in multiple etiologies, including liver steatosis. In diabetic patients with metabolic-associated fatty liver disease (MAFLD), widely used non-invasive scoring systems, particularly the fibrosis-4 (FIB-4) score, showed unsatisfactory performance in predicting liver fibrosis severity. The aim of this study was to evaluate the productivity of serum PDGFRβ as a non-invasive biomarker of liver fibrosis in diabetic MAFLD patients.
METHODS
This was a population-based case-control study conducted on 50 diabetic MAFLD patients, 40 nondiabetic MAFLD patients, and 40 healthy controls. All subjects underwent complete history taking, clinical examination, anthropometric measurements, bioelectrical impedance analysis (BIA), and laboratory tests, including the PDGFRβ assay. Hepatic steatosis was assessed with magnetic resonance imaging (MRI), along with magnetic resonance elastography (MRE) for the assessment of liver fibrosis. The diagnostic performance of PDGFRβ as well as PDGFRβ + FIB-4 in prediction of significant liver fibrosis in diabetic MAFLD patients was assessed.
RESULTS
Liver steatosis and significant liver fibrosis (≥ F2) were significantly higher in diabetic MAFLD patients than in nondiabetics. PDGFRβ levels were significantly higher in both diabetic and nondiabetic MAFLD patients compared to controls. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PDGFRβ to predict significant liver fibrosis in diabetic MAFLD patients were 85%, 93.33%, 89.5%, and 90.3%, respectively, at a cutoff > 2.54, and were 85.71%, 51.52%, 27.3%, and 94.4% at a cutoff > 1.59 in nondiabetics. Sensitivity, specificity, PPV, and NPV of (PDGFRβ at a cutoff > 2.54 + FIB-4 at a cutoff > 1.17) to predict significant liver fibrosis in diabetic MAFLD patients were 100%. PDGFRβ was the only independent predictor of significant liver fibrosis in diabetic MAFLD (p = 0.006).
CONCLUSIONS
PDGFRβ proved efficacy as a noninvasive biomarker in the prediction of significant liver fibrosis (≥ F2) in diabetic MAFLD patients.
背景
最近发现循环血小板衍生生长因子受体-β（PDGFRβ）与多种病因的肝病严重程度相关，包括肝脂肪变性。在患有代谢相关脂肪性肝病（MAFLD）的糖尿病患者中，广泛使用的非侵入性评分系统，尤其是纤维化-4（FIB-4）评分，在预测肝纤维化严重程度方面表现不尽人意。本研究的目的是评估血清PDGFRβ作为糖尿病MAFLD患者肝纤维化非侵入性生物标志物的效能。
方法
这是一项基于人群的病例对照研究，纳入了50例糖尿病MAFLD患者、40例非糖尿病MAFLD患者和40例健康对照。所有受试者均接受了完整的病史采集、临床检查、人体测量、生物电阻抗分析（BIA）以及实验室检查，包括PDGFRβ检测。采用磁共振成像（MRI）评估肝脂肪变性，并采用磁共振弹性成像（MRE）评估肝纤维化。评估了PDGFRβ以及PDGFRβ + FIB-4在预测糖尿病MAFLD患者显著肝纤维化方面的诊断效能。
结果
糖尿病MAFLD患者的肝脂肪变性和显著肝纤维化（≥F2）明显高于非糖尿病患者。与对照组相比，糖尿病和非糖尿病MAFLD患者的PDGFRβ水平均显著升高。在糖尿病MAFLD患者中，PDGFRβ预测显著肝纤维化的敏感性为85%、特异性为93.33%、阳性预测值（PPV）为89.5%、阴性预测值（NPV）为90.3%，截断值>2.54；在非糖尿病患者中，截断值>1.59时，敏感性为85.71%、特异性为51.52%、PPV为27.3%、NPV为94.4%。（截断值>2.54的PDGFRβ + 截断值>1.17的FIB-4）预测糖尿病MAFLD患者显著肝纤维化的敏感性、特异性、PPV和NPV均为100%。PDGFRβ是糖尿病MAFLD患者显著肝纤维化的唯一独立预测因子（p = 0.006）。
结论
PDGFRβ被证明是预测糖尿病MAFLD患者显著肝纤维化（≥F2）的有效非侵入性生物标志物。
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