新疆医科大学学报2024，Vol.47Issue(7) ：1001-1007.DOI:10.3969/j.issn.1009-5551.2024.07.016

血清AMPK-αmRNA、Caspase-6 mRNA水平对非酒精性脂肪肝疗效的预测价值及影响因素分析

Predictive value and influencing factors of serum AMPK-αmRNA and Caspase-6 mRNA levels in therapeutic efficacy of non-alcoholic fatty liver disease(NAFLD)

刘春华 马丽敏 刘凤华 刘英果
新疆医科大学学报2024，Vol.47Issue(7) ：1001-1007.DOI:10.3969/j.issn.1009-5551.2024.07.016
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血清AMPK-αmRNA、Caspase-6 mRNA水平对非酒精性脂肪肝疗效的预测价值及影响因素分析

Predictive value and influencing factors of serum AMPK-αmRNA and Caspase-6 mRNA levels in therapeutic efficacy of non-alcoholic fatty liver disease(NAFLD)

刘春华 1马丽敏 1刘凤华 1刘英果2
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作者信息

  • 1. 聊城市人民医院感染性疾病科
  • 2. 聊城市传染病医院感染性疾病科,山东 聊城 252000
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摘要

目的 分析血清腺苷酸活化蛋白激酶-αmRNA(Adenosine monophosphate activated protein kinase α,AMPK-αmRNA)、半胱氨酸天冬氨酸蛋白 酶-6(Cystein-asparate protease,caspase-6)mRNA 水平对非酒精性脂肪肝(Non-alcoholic fatty liver disease,NAFLD)疗效的预测价值及影响因素.方法 选取2021年10月-2023年8月聊城市人民医院感染性疾病科收治的188例NAFLD患者为研究对象,治疗6个月后以甘油三酯(TG)降低≥20％和(或)总胆固醇(TC)降低≥10％判断为治疗有效,归入有效组,否则判断为治疗无效,归入无效组.所有患者治疗前后检测血清AMPK-αmRNA、Caspase-6 mRNA水平.收集NAFLD患者一般资料,分析NAFLD疗效的影响因素.绘制受试者工作特征(Receiver operating characteristic curve,ROC)曲线分析血清AMPK-αmRNA,Caspase-6 mRNA水平对NAFLD疗效的预测价值.结果 188例NAFLD患者治疗6个月脱落6例,有效随访182例,其中治疗有效126例(69.23％),纳入有效组,治疗无效56例(30.77％),纳入无效组.与本组治疗前比较,治疗6个月后患者血清AMPK-αmRNA水平升高,Caspase-6 mRNA水平降低,差异有统计学意义(P＜0.05).与无效组比较,有效组治疗前、治疗6个月血清AMPK-αmRNA水平升高,Caspase-6 mRNA水平降低,差异有统计学意义(P＜0.05).患有糖尿病,血清TC、TG、低密度脂蛋白胆固醇(Low-density lipoprotein,LDL-C)、谷丙转氨酶(Alanime aminotransferase,ALT)、谷草转氨酶(Aspartate aminotransferase,AST),Caspase-6 mRNA水平是NAFLD疗效的独立危险因素,治疗前血清AMPK-αmRNA水平是其独立保护因素(P＜0.05).建立 Logistic 回归模型:logit(P)=-29.182-0.867 × AMPK-αmRNA+0.890 × Caspase-6 mRNA+1.956× 糖尿病+1.283×TG+0.982×TC+0.703 × LDL-C+0.066× ALT+0.101 × AST,拟合度较好.治疗前血清 AMPK-αmRNA、Caspase-6 mRNA 水平及Logistic回归模型预测NAFLD疗效的曲线下面积(Area under curve,AUC)值分别为0.757、0.717、0.816,Logistic 回归模型的预测价值大于 AMPK-αmRNA,Caspase-6 mRNA 单独评估价值(Z=2.149,P=0.032;Z=2.879,P=0.004).结论 患者是否患有糖尿病,血清TG、TC、LDL-C、ALT、AST、AMPK-αmRNA、Caspase-6 mRNA 水平是 NAFLD 疗效的影响因素,检测血清AMPK-αmRNA、Caspase-6 mRNA水平对NAFLD疗效具有一定预测价值.

Abstract

Objective To analyze the predictive value and influencing factors of serum adenosine monophos-phate activated protein kinase alpha(AMPK-α mRNA)and caspase-6 mRNA levels on the efficacy of non-alcoholic fatty liver disease(NAFLD).Methods 188 NAFLD patients admitted to the hospital from Oc-tober 2021 to August 2023 were selected as study subjects.After 6 months of thetreatment,the treatment was judged to be effective if the triglyceride(TG)wasdecreased by≥20％and/or the total cholesterol(TC)wasdecreased by ≥ 10％,and they were classified into the effective group.Otherwise,the treat-ment was judged to be ineffective and they were classified into ineffective group.All patients were tested for serum AMPK-α mRNA and Caspase-6 mRNA levels before and after the treatment.Collected general information of NAFLD patients and analyzed the influencing factors of NAFLD efficacy.Receiver operat-ing characteristic curve(ROC)curvewas drawnto analyze the predictive value of serum AMPK-α mRNA and Caspase-6 mRNA levels on the efficacy of NAFLD.Results Of 188 cases,6 cases fell off after 6 months of thetreatment,182 cases were effectively followed up,of which 126 cases(69.23％)were effec-tive and included in the effective group,and 56 cases(30.77％)were found to be ineffective in treatment and wereincluded in the ineffective group.Compared with before the treatment in the same group,the ser-um AMPK-αmRNA level wasincreased significantly,while the Caspase-6 mRNA level was decreased sig-nificantly after 6 months of the treatment,with a statistically significant difference(P＜0.05).Compared with the ineffective group,the serum AMPK-αmRNA level in the effective group was significantly in-creased before the treatment and after 6 months of thetreatment,while the Caspase-6 mRNA level was significantly decreased(P＜0.05).Diabetes,serum TC,TG,low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and Caspase-6 mRNA levels were in-dependent risk factors for the therapeutic effect of NAFLD,while serum AMPK-αmRNA level before treatment was an independent protective factor(P＜0.05).Logistic regression model was established:logit(P)=-29.182-0.867 × AMPK-αm RNA+0.890 × Caspase-6 mRNA+1.956 × diabetes mellitus+1.283×TG+0.982× TC+0.703 × LDL-C+0.066 × ALT+0.101 × AST,and the fitting degree was good.The AUC values of serum AMPK-αmRNA and Caspase-6 mRNA levels before the treatment and Logistic regression model were 0.757,0.717 and 0.816,respectively,and the predictive value of Logistic regression model was greater than AMPK-αmRNA.Caspase-6 mRNA was evaluated separately(Z=2.149,P=0.032;Z=2.879,P=0.004).Conclusion Whether a patient has diabetes,as well as the ser-um levels of TG,TC,LDL-C,ALT,AST,AMPK-αmRNA and Caspase-6 mRNA,are all influencing factors for the therapeutic effect of NAFLD.The detection of AMPK-αmRNA and Caspase-6 mRNA has certain predictive value for the therapeutic effect of NAFLD.

关键词

非酒精性脂肪肝/影响因素/腺苷酸活化蛋白激酶-α/微小核糖核酸/半胱氨酸天冬氨酸蛋白酶-6

Key words

non-alcoholic fatty liver(NAFLD)/influencing factors/adenosine monophosphate activated protein kinase α(AMPK-α)/micrornas/cysteine aspartate protease-6(Caspase-6)

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基金项目

山东省医药卫生科技发展计划项目(2022WH173-02)

出版年

2024
新疆医科大学学报
新疆医科大学

新疆医科大学学报

CSTPCD
影响因子：0.76
ISSN：1009-5551
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