血清脂肪细胞型脂肪酸结合蛋白对非酒精性脂肪性肝病的预测价值

肝脏 ›› 2021, Vol. 26 ›› Issue (2): 187-191.

血清脂肪细胞型脂肪酸结合蛋白对非酒精性脂肪性肝病的预测价值

汶倩, 王晓叶, 赵丽, 张哲, 李武良, 赵曙光, 陶梅

710054 陕西西安西安交通大学附属西安市第九医院消化科(汶倩,王晓叶,李武良,陶梅);空军军医大学附属唐都医院消化科(赵丽,张哲,赵曙光)

收稿日期:2020-04-01 出版日期:2021-02-28 发布日期:2021-03-28
通讯作者: 陶梅,Email: wu-taomei@163.com; 赵曙光,Email: zsg1203@126.com
基金资助:
陕西省社会发展科技攻关项目(2016SF-303)

The predictive value of serum A-FABP for diagnosis of NAFLD

WEN Qian¹, WANG Xiao-ye¹, ZHAO Li², ZHANG Zhe², LI Wu-liang¹, ZHAO Shu-guang², TAO Mei¹

1. Department of gastroenterology, the Ninth Hospital of xi'an Jiaotong University, Shaanxi 710054, China;
2. Department of gastroenterology, Tangdu Hospital, Air Force Medical University of PLA, xi'an 710038, China

Received:2020-04-01 Online:2021-02-28 Published:2021-03-28
Contact: TAO Mei,Email: wu-taomei@163.com; ZHAO Shu-guang,Email: zsg1203@126.com

摘要/Abstract

摘要： 目的研究血清脂肪细胞型脂肪酸结合蛋白 (A-FABP)对非酒精性脂肪性肝病(NAFLD)的预测价值。方法收集NAFLD患者及正常对照各86人,收集年龄、性别、身高、体重、BMI、腰围等指数,检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、尿酸(UA)、超敏C反应蛋白(hsCRP)、脂肪细胞型脂肪酸结合蛋白(A-FABP)及肿瘤坏死因子-α(TNF-α),绘制受试者操作特征曲线(ROC曲线),计算A-FABP预测NAFLD的界值,验证预测效能,并进行A-FABP与TNF-α的相关性分析。结果与对照组相比,NAFLD组患者身高、体重、BMI、腰围、TC、TG、LDL-C、FPG、ALT、AST、γ-GT、UA、hsCRP、A-FABP及TNF-α均升高( P<0.05),而HDL-C显著降低( P<0.01)。A-FABP分界值为82.43 pg/mL时,NAFLD诊断灵敏度97.7%,特异度93.0%,阳性预测值93.3%,阴性预测值97.6%,总符合率为95.3%,Kappa值为0.907。 Spearman及Pearson相关分析均显示NAFLD患者血清A-FABP和TNF-α、UA、BMI呈正相关和HDL-C呈负相关(P<0.05)。多元线性回归显示TNF-α和UA为影响A-FABP的独立因素。结论 A-FABP作为联系代谢紊乱与炎症反应的关键因素,A-FABP分界值设定为82.43 pg/mL对NAFLD具有良好的预测价值。

关键词: 非酒精性脂肪性肝病, 脂肪细胞型脂肪酸结合蛋白, 肿瘤坏死因子-α, 受试者操作特征曲线

Abstract: Objective To explore the predictive value of serum adipocyte fatty acid-binding protein (A-FABP) for the diagnosis of non-alcoholic fatty liver disease (NAFLD).Methods Eighty-six cases of NAFLD (NAFLD group) patients and 86 healthy adults (control group) were enrollled. Age, gender, height, weight, BMI, waist circumference were assessed. The level of serum TC, TG, HDL-C, LDL-C, FPG, ALT, AST, γ-GT, UA, hsCRP, A-FABP, TNF-α were measured. The receiver operating characteristic curve (ROC curve) was plotted, the NAFLD threshold of A-FABP was calculated, the predictive efficacy was verified, and the correlation between A-FABP and TNF-α was analyzed. Results Compared with the control group, the height, weight, waist circumference, BMI, TG, TC, LDL-C, FPG, ALT, AST, γ-GT, UA, hsCRP, the level of serum A-FABP and TNF-α in the NAFLD group were increased(P<0.05), while HDL-C were decreased significantly (P<0.01). When the A-FABP cutoff value was 82.43 pg/mL, the diagnostic sensitivity of NAFLD was 97.7%, the specificity was 93.0%, the positive predictive value was 93.3%, the negative predictive value was 97.6%, the overall coincidence rate was 95.3%, and the consistency test statistic Kappa was 0.907. The spearman or pearson correlation analysis revealed that the A-FABP level was positively correlated with TNF-α, UA and BMI, while was negatively correlated with HDL-C (P<0.05). Multiple linear regression showed that TNF-α and UA were independent factors affecting A-FABP.Conclusion A-FABP play important roles in the liver function impairment and inflammatory response, and is a good serum predictor for NAFLD with a cutoff value of 82.43 pg/mL.

Key words: Non-alcoholic fatty liver disease, Fatty acid-binding proteins, Tumor necrosis factor-alpha, The receiver operating characteristic curve

汶倩, 王晓叶, 赵丽, 张哲, 李武良, 赵曙光, 陶梅. 血清脂肪细胞型脂肪酸结合蛋白对非酒精性脂肪性肝病的预测价值[J]. 肝脏, 2021, 26(2): 187-191.

WEN Qian, WANG Xiao-ye, ZHAO Li, ZHANG Zhe, LI Wu-liang, ZHAO Shu-guang, TAO Mei. The predictive value of serum A-FABP for diagnosis of NAFLD[J]. Chinese Hepatolgy, 2021, 26(2): 187-191.

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