摘要
目的探讨血浆高尔基体蛋白73(GP73)水平与非酒精性脂肪性肝病(NAFLD)发生和发展的关系,并以此为基础联合脂代谢指标建立诊断模型,明确其诊断NAFLD的效能及临床应用价值。方法选择河北医科大学第三医院中西医结合肝病科及体检中心经超声及肝脏瞬时弹性成像(FibroScan502)检测(部分患者行肝活组织病理学检查)确诊的NAFLD患者225例,健康对照组108名。收集患者临床资料、外周血常规及血清生物化学检测结果。血浆GP73水平采用酶联免疫吸附法检测。应用SPSS 21.0统计学软件进行统计学分析,二元Logistic回归模型计算NAFLD的诊断模型,应用受试者操作特征曲线,评估所建模型对NAFLD的诊断效能。结果NAFLD发病显著趋于年轻化,以青壮年男性为多,随着年龄的增长,女性患病比率增多。年龄构成比分析结果显示,20~50岁为NAFLD患病主要年龄段,其中30~39岁患病比率高达47%,60岁以上患病比率明显下降(4.00%)。GP73可作为NAFLD发生和发展的独立危险因素,以GP73(G)联合人体质量指数(BMI,B)、血清甘油三酯(TG,T)建立GBT、GB、GT诊断模型,结果证实,GBT、GB、GT模型曲线下面积依次为0.969、0.937、0.909,灵敏度依次为84.90%、77.80%、84.00%,特异度分别为95.40%、95.40%、82.40%,P<0.05,以GBT模型诊断效能最佳。结论NAFLD以男性青壮年患病多见,随年龄增长,女性患者逐渐增多;血浆GP73水平与NAFLD发生和发展有关;GBT模型可作为NAFLD无创诊断新模型,亦可作为临床诊断及疗效评估的指标之一。
Objective To investigate the relationship between plasma Golgi protein 73(GP73)levels and the occurrence and development of non-alcoholic fatty liver disease(NAFLD),and to establish a diagnostic model based on this combination with lipid metabolism indicators to clarify its diagnostic efficacy and clinical application value for NAFLD.Methods 225 cases with NAFLD[diagnosed by ultrasound,transient elastography(FibroScan502)and liver biopsy(some patients)]and 108 healthy controls were selected from the Department of Hepatology and Physical Examination Center of Integrated Traditional Chinese and Western Medicine,The Third Hospital of Hebei Medical University.Clinical data,routine peripheral blood and serum biochemical test results were collected.The plasma GP73 level was detected by enzyme-linked immunosorbent assay.SPSS 21.0 statistical software was used for statistical analysis.Binary logistic regression model was used to calculate the NAFLD diagnostic model.Receiver operating characteristic curve was used to evaluate the NAFLD constructed model diagnostic efficacy.Results NAFLD incidence was significantly reduced in younger age group,mostly in young and middle-aged male.However,the NAFLD incidence was increased with increasing age in female.The analysis of age ratio composition showed that the average age for NAFLD onset was 20~50 years old,and the incidence rate was as high as 47%in among 30~39 years old,but the incidence rate was significantly decreased in over 60 years old(4.00%).GP73 was an independent risk factor for the occurrence and development of NAFLD.The diagnostic models of GBT,GB and GT were established by GP73(G)combined with body mass index(BMI,B)and serum triglyceride(TG,T),and the results showed that the areas under the curves of GBT,GB and GT models were 0.969,0.937 and 0.909,respectively.The sensitivity and the specificity were 84.90%,77.80%and 84.00%,and 95.40%,95.40%and 82.40%,respectively,P<0.05.The GBT model had efficacy of best diagnostic performance.Conclusion NAFLD is more common in young and middle-aged male,but with advanced age,the incidence of female patients gradually increases.Plasma GP73 levels are related to the occurrence and development of NAFLD.The GBT model can be used as a new model for non-invasive diagnosis and one of the indicators for clinical evaluation of diagnostic efficacy of NAFLD.
作者
王一奇
苑喜微
李冬冬
汤玉会
薛宁宁
崔璐瑶
刘领弟
南月敏
Wang Yiqi;Yuan Xiwei;Li Dongdong;Tang Yuhui;Xue Ningning;Cui Luyao;Liu Lingdi;Nan Yuemin(Department of Traditional and Western Medical Hepatology,Third Hospital of Hebei Medical University,Hebei Key Laboratory of Mechanism of Liver Fibrosis in Chronic Liver Disease,Shijiazhuang 050051,China)
出处
《中华肝脏病杂志》
CSCD
北大核心
2021年第12期1170-1176,共7页
Chinese Journal of Hepatology
基金
国家自然科学基金(81970504)
河北省自然科学基金项目(H2018206326)。
