首页|非酒精性脂肪性肝病患者血清IL-1RA、CTRP13和CK-18水平变化及其临床意义探讨

非酒精性脂肪性肝病患者血清IL-1RA、CTRP13和CK-18水平变化及其临床意义探讨

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目的 探讨非酒精性脂肪性肝病(NAFLD)患者血清白细胞介素-1 受体拮抗剂(IL-1RA)、补体C1q肿瘤坏死因子相关蛋白13(CTRP13)和细胞角蛋白18(CK-18)水平变化及其临床意义。方法 2021 年1 月~2023 年1 月我院收治的67 例NAFLD患者和55 例健康体检者,经肝活检诊断肝脏脂肪变性分级,采用 ELISA法检测血清 IL-1RA、CTRP13 和CK-18 水平。应用多元Logistic回归分析危险因素。结果 NAFLD组血清IL-1RA和CTRP13 水平分别为(328。6±54。3)pg/ml和(2634。2±397。5)pg/ml,显著低于健康人组[分别为(673。1±125。4)pg/ml和(3425。7±423。8)pg/ml,P<0。05],而血清CK-18 水平为(15。2±3。1)ng/ml,显著高于健康人组[(3。9±0。7)ng/ml,P<0。05];17 例F3 级肝脂肪变性患者血清IL-1RA和CTRP13 水平分别为(256。3±47。6)pg/ml和(2056。3±308。4)pg/ml,显著低于29 例F1 级患者[分别为(388。3±59。4)pg/ml和(3071。5±409。3)pg/ml,P<0。05]或21 例F2 级患者[分别为(304。7±50。1)pg/ml和(2498。1±374。2)pg/ml,P<0。05],而血清CK-18 水平为(23。4±4。7)ng/ml,显著高于F1 级患者[(8。1±1。3)ng/ml,P<0。05]或F2级患者[(18。5±2。9)ng/ml,P<0。05];F3 级肝脂肪变性患者肥胖、合并糖尿病、合并高脂血症、有代谢综合征家族史、血清IL-1RA≥256。5pg/ml、CTRP13≥2056。5pg/ml 和 CK-18≥21。6 ng/ml 占比分别为 70。6%、76。5%、88。2%、70。6%、35。3%、35。3%和70。6%,与50 例F1/F2 级的38。0%、42。0%、40。0%、30。0%、92。0%、80。0%和10。0%比,差异显著(P<0。05);多因素Logistic回归分析表明,肥胖[OR(95%)为2。0(1。1~3。6)]、合并糖尿病[OR(95%)为 2。1(1。1~4。1)]、合并高脂血症[OR(95%)为1。6(1。0~2。6)]、IL-1RA[OR(95%)为0。5(0。3~0。9)]、CTRP13[OR(95%)为0。5(0。3~0。9)]和CK-18[OR(95%)为 1。7(1。2~2。5)]为影响NAFLD患者肝脏脂肪变性程度的危险因素(P<0。05)。结论 NAFLD患者血清IL-1RA、CTRP13 和CK-18 水平异常变化可能为评估肝脏脂肪变性程度提供一定的依据。
Changes of serum IL-1RA,CTRP13 and CK-18 levels in patients with non-alcoholic fatty liver diseases
Objective The aim of this study was to explore the clinical implications of serum interleukin-1 receptor antagonist(IL-1RA),complement C1q tumor necrosis factor related protein 13(CTRP13)and cytokeratin 18(CK-18)levels in patients with non-alcoholic fatty liver diseases(NAFLD).Methods 67 patients with NAFLD and 55 healthy individuals at physical examination were enrolled in our hospital between January 2021 and January 2023,and all patients received liver biopsies for hepatic steatosis classification.Serum IL-1RA,CTRP13 and CK-18 levels were detected by ELISA,and the risk factors for severe liver steatosis was determined by multivariate Logistic regression analysis.Results Serum IL-1RA and CTRP13 levels in patients with NAFLD were(328.6±54.3)pg/ml and(2634.2±397.5)pg/ml,both significantly lower than[(673.1±125.4)pg/ml and(3425.7±423.8)pg/ml,P<0.05],while serum CK-18 level was(15.2±3.1)ng/ml,significantly higher than[(3.9±0.7)ng/ml,P<0.05]in healthy persons;serum IL-1RA and CTRP13 levels in 17 patients with severe liver steatosis of F3 were(256.3±47.6)pg/ml and(2056.3±308.4)pg/ml,significantly lower than[(388.3±59.4)pg/ml and(3071.5±409.3)pg/ml,P<0.05]in 29 patients with F1 steatosis or[(304.7±50.1)pg/ml and(2498.1±374.2)pg/ml,P<0.05]in 21 patients with F2 steatosis,while serum CK-18 level was(23.4±4.7)ng/ml,significantly higher than[(8.1±1.3)ng/ml,P<0.05]in patients with F1 or[(18.5±2.9)ng/ml,P<0.05]in patients with F2 steatosis;the percentages of concomitant obesity,diabetes mellitus,hyperlipidemia,family history of metabolic syndromes,low serum IL-1RA and CTRP13,and high serum CK-18 levels in patients F3 steatosis were 70.6%,76.5%,88.2%,70.6%,35.3%,35.3%and 70.6%,significantly different compared to 38.0%,42.0%,40.0%,30.0%,92.0%,80.0%and 10.0%in 50 patients with F1/F2 steatosis(P<0.05);the multivariate Logistic regression analysis showed that the obesity[OR(95%):2.0(1.1-3.6)],diabetes[OR(95%):2.1(1.1-4.1)],hyperlipidemia[OR(95%):1.6(1.0-2.6)],low serum IL-1RA[OR(95%):0.5(0.3-0.9)]and CTRP13[OR(95%):0.5(0.3-0.9)]and high serum CK-18[OR(95%):1.7(1.2-2.5)]were the risk factors for severe liver steatosis in patients with NAFLD(P<0.05).Conclusion The abnormal changes of serum IL-1RA,CTRP13 and CK-18 levels in patients with NAFLD might help evaluate hepatic steatosis,and warrants further clinical investigation.

Non-alcoholic fatty liver diseasesInterleukin-1 receptor antagonistComplement C1q tumor necrosis factor related protein 13Cytokeratin 18Implications

高洋、张静、卢宣霖

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400000 重庆市 重庆大学附属肿瘤医院检验科

重庆两江新区人民医院检验科

非酒精性脂肪性肝病 白细胞介素-1受体拮抗剂 补体C1q肿瘤坏死因子相关蛋白13 细胞角蛋白18 临床意义

重庆市科技局科研基金资助项目

2021KJ03401

2024

实用肝脏病杂志
中华医学会安徽分会

实用肝脏病杂志

CSTPCD
影响因子:1.362
ISSN:1672-5069
年,卷(期):2024.27(2)
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