摘要
目的探讨血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在非酒精性脂肪性肝病(NAFLD)患者中的表达情况,并分析其与肝脏组织病理特征的关系及对非酒精性脂肪性肝炎(NASH)的诊断效能。方法回顾性选取2020年1月至2023年4月温州医科大学附属第一医院收治的NAFLD患者234例(NAFLD组),其中NASH患者126例(NASH组)和单纯的肝脂肪变性(NAFL)患者108例(NAFL组)。另择同期本院100名体检健康者作为对照组。检测并比较NASH组、NAFL组及对照组血清NGAL水平;分析NAFLD组患者血清NGAL水平与肝脏组织病理特征的相关性、NAFLD发生的危险因素以及血清NGAL水平对NASH的诊断效能。结果NASH组和NAFL组的血清NGAL水平均高于对照组(均P<0.05),NASH组又高于NAFL组(P<0.05)。NASH组患者肝脏组织在脂肪变性、气球样变、小叶内炎症和纤维化程度方面与NAFL组比较差异均有统计学意义(均P<0.05)。Spearman秩相关分析显示,无论是NASH组患者还是NAFL组患者,血清NGAL水平与肝脏组织脂肪变性评分、气球样改变评分、小叶内炎症评分、纤维化分级和NAFLD活动度评分均呈正相关(均P<0.05)。高血清NGAL水平是NAFLD发生的独立危险因素(P<0.05)。ROC曲线分析显示,血清NGAL水平诊断NASH的AUC为0.998,特异度为1.000,灵敏度为0.960,最佳截断值为49.23 g/mL,血清NGAL水平对NASH有较高的诊断效能。结论NAFLD患者血清NGAL表达上调,且进展至NASH的患者血清NGAL水平更高,其对NASH有较高的诊断效能。
Objective To investigate the expression of serum neutrophil gelatinase-associated lipocalin(NGAL)levels in patients with non-alcoholic fatty liver disease(NAFLD)and analyze its relationship with the histopathological features of the liver and its diagnostic efficacy for non-alcoholic steatohepatitis(NASH).Methods A total of 234 patients with NAFLD diagnosed between January 2020 and April 2023 at the First Affiliated Hospital of Wenzhou Medical University were included(NAFLD group).This group comprised 126 patients with NASH(NASH group)and 108 patients with just hepatic steatosis(NAFL group).Additionally,a control group of 100 healthy individuals who underwent physical examinations at the same hospital and the same period was recruited.Serum NGAL levels were measured and compared across the NASH group,NAFL group,and the control group.The correlation between serum NGAL levels and the histopathological characteristics of the liver in the NASH and NAFL groups was analyzed.Risk factors for NAFLD occurrence were also analyzed,and the efficacy of serum NGAL levels in diagnosing NASH was evaluated.Results The serum NGAL levels in the NASH and NAFL groups were significantly higher than those of the control group(both P<0.05).Furthermore,the serum NGAL levels in the NASH group were significantly higher than those of the NAFL group(P<0.05).Liver tissues from patients in the NASH group exhibited significant differences compared to the NAFL group in terms of steatosis,ballooning,intralobular inflammation,and fibrosis grades(all P<0.05).Spearman rank correlation analysis revealed a positive correlation between serum NGAL levels and scores of liver tissue steatosis,ballooning,and intralobular inflammation,and fibrosis grading in both the NASH and NAFL groups(all P<0.05).High serum NGAL level was identified as an independent risk factor for developing NAFLD(P<0.05).ROC curve analysis demonstrated an area under the curve(AUC)of 0.998 for serum NGAL level in diagnosing NASH.This analysis also revealed 1.000 specificity,0.960 sensitivity,and an optimal cut-off value of 49.23 g/mL.Serum NGAL levels demonstrate high diagnostic efficacy for NASH.Conclusion Serum NGAL levels are up-regulated in NAFLD patients,with even higher levels observed in those who progressed to NASH.Notably,these levels demonstrate high diagnostic efficacy for NASH.
作者
应芙蓉
金宣辰
曾靖
陈宇轩
施雨晗
赵志超
YING Furong;JIN Xuanchen;ZENG Jing;CHEN Yuxuan;SHI Yuhan;ZHAO Zhichao(Department of Clinical Laboratory,Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;不详)
出处
《浙江医学》
CAS
2024年第9期926-931,937,共7页
Zhejiang Medical Journal
基金
温州市基础性科研项目(Y20220745)
浙江省检验诊断及转化研究重点实验室(2022E10022)。
