首页|非酒精性脂肪性肝病患者血清HIF-1α、HMGB1和脂联素水平变化及其与颈动脉粥样硬化的关系研究

非酒精性脂肪性肝病患者血清HIF-1α、HMGB1和脂联素水平变化及其与颈动脉粥样硬化的关系研究

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目的 探讨非酒精性脂肪性肝病(NAFLD)患者血清低氧诱导因子-1α(HIF-1α)、高迁移率族蛋白 1(HMGB1)和脂联素(APN)水平变化及其与颈动脉粥样硬化(CAS)的关系。方法 2018 年5 月~2023 年3 月我院诊治的NAFLD患者158 例(其中合并CAS者71 例),使用Fibrotouch弹性成像仪诊断脂肪肝,使用超声诊断仪检测颈动脉斑块形成。采用ELISA法检测血清HIF-1α、HMGB1 和APN水平,应用二元Logistic回归分析NAFLD合并CAS的影响因素,应用受试者工作特征曲线下面积(AUC)评估血清指标预测NAFLD患者合并CAS的效能。结果 合并CAS组收缩压为(137。1±10。3)mmHg,显著高于未合并CAS组[(132。9±8。2)mmHg,P<0。05];合并CAS组血清TC、LDL-C、HIF-1α和HMGB1 水平分别为(6。5±2。3)mmol/L、(3。7±0。6)mmol/L、(25。7±6。5)pg/L和(9。4±2。3)ng/ml,显著高于未合并CAS组[分别(5。1±1。7)mmol/L、(2。8±0。3)mmol/L、(17。2±4。1)pg/L和(6。1±1。5)ng/ml,P<0。05],而血清APN为(7。5±3。0)mg/L,显著低于未合并 CAS 组[(12。8±4。6)mg/L,P<0。05];多因素 Logistic 回归分析显示,TC(OR=1。411,95%CI:1。133~1。757)、LDL-C(OR=1。419,95%CI:1。128~1。785)、HIF-1α(OR=1。504,95%CI:1。182~1。914)、HMGB1(OR= 1。520,95%CI:1。206~1。916)和APN(OR=1。530,95%CI:1。226~1。909)均是影响NAFLD患者合并CAS的独立危险因素(P<0。05);ROC曲线分析显示,血清HIF-1α、HMGB1 和APN水平联合预测NAFLD患者合并CAS的AUC为0。863,其敏感度为94。5%,特异度为75。0%,优于各指标单独预测(P<0。05)。结论 NAFLD患者血清HIF-1α和HMGB1 水平升高而血清APN水平降低是发生CAS的危险因素,应及时发现和给予必要的干预。
Changes of serum HIF-1α,HMGB1 and adiponectin levels in patients with non-alcoholic fatty liver diseases and their correlation to carotid atherosclerosis
Objective The aim of this study was to investigate the changes of serum hypoxia inducible factor-1α(HIF-1α),high-mobility group box 1(HMGB1)and adiponectin(APN)levels in patients with non-alcoholic fatty liver diseases(NAFLD)and their correlation to carotid atherosclerosis(CAS).Methods 158 patients with NAFLD,including concomitant CAS in 71 cases,were encountered in our hospital between May 2018 and March 2023,and the NAFLD was diagnosed based on Fibrotouch detection and the CAS was determined by ultrasonography.Serum HIF-1α,HMGB1 and APN levels were assayed by ELISA,the risk factors was revealed by multivariate Logistic regression analysis and predicting performance was evaluated by the area under the receiver operating characteristic curve(AUC).Results The systolic blood pressure in patients NAFLD and concomitant CAS was(137.1±10.3)mmHg,much higher than[(132.9±8.2)mmHg,P<0.05]in NAFLD patients without CAS;serum TC,LDL-C,HIF-1α and HMGB1 levels were(6.5±2.3)mmol/L,(3.7±0.6)mmol/L,(25.7±6.5)pg/L and(9.4±2.3)ng/ml,all significantly higher than[(5.1±1.7)mmol/L,(2.8±0.3)mmol/L,(17.2±4.1)pg/L and(6.1±1.5)ng/ml,respectively,P<0.05],while serum APN level was(7.5±3.0)mg/L,much lower than[(12.8±4.6)mg/L,P<0.05]in those without CAS;the multivariate Logistic regression analysis showed that serum TC(OR=1.411,95%CI:1.133-1.757),LDL-C(OR=1.419,95%CI:1.128-1.785),HIF-1α(OR=1.504,95%CI:1.182-1.914),HMGB1(OR=1.520,95%CI:1.206-1.916)and APN(OR=1.530,95%CI:1.226-1.909)were all the risk factors impacting CAS occurrence in patient with NAFLD(P<0.05);the ROC analysis demonstrated that the AUC was 0.863,with the sensitivity of 94.5%and the specificity of 75.0%when the combination of serum HIF-1α,HMGB1 and APN levels was applied to predict the CAS existence,much superior to any single parameter did(P<0.05).Conclusion The elevated serum HIF-1α and HMGB1 levels and the decreased serum APN level are all risk factors for the occurrence of CAS in patients with NAFLD,which might be intervened as sooner as possible.

Non-alcoholic fatty liver diseasesCarotid atherosclerosisHypoxia inducible factor-1αHigh-mobility group box 1AdiponectinDiagnosis

郑波、哈丽达·夏尔甫哈孜、谈理

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610100 成都市四川护理职业学院附属医院/四川省第三人民医院消化内科

新疆医科大学第一附属医院消化病二科

非酒精性脂肪性肝病 颈动脉斑块形成 低氧诱导因子-1α 高迁移率族蛋白1 脂联素 诊断

四川省科技厅科研基金资助项目

2021LJ0240001

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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