血清脂联素、肝细胞生长因子水平对非酒精性脂肪肝的诊断价值-东南大学学报医学版

血清脂联素、肝细胞生长因子水平对非酒精性脂肪肝的诊断价值

单位：1. 衡水市第三人民医院消化一科, 河北衡水 053000;
2. 衡水市第三人民医院呼吸与危重症医学科一科, 河北衡水 053000

分类号：R575;R446.1

出版年·卷·期（页码）：2024·43·第五期（698-703）

摘要：

目的: 探讨血清脂联素(ADPN)、肝细胞生长因子(HGF)水平在非酒精性脂肪肝(NAFLD)诊断、病情严重程度评估中的价值。方法: 选取2021年5月至2023年5月来我院治疗的NAFLD患者作为患病组(n=100),根据病情严重程度进一步分为重度组(n=31)、中度组(n=33)和轻度组(n=36),另选取同期于本院参加健康体检的人群作为对照组(n=100)。采用ELISA法对血清ADPN、HGF水平进行检测;Logistic回归分析重度NAFLD发生的影响因素;ROC曲线分析血清ADPN、HGF水平对NAFLD及重度NAFLD的诊断价值。结果: 与对照组相比,患病组血清ADPN水平显著下降,HGF水平显著升高(P<0.05);血清ADPN、HGF二者联合诊断NAFLD的曲线下面积(AUC)均高于二者单独诊断(0.859 vs 0.790、0.744,Z_{二者联合-ADPN}=2.033、Z_{二者联合-HGF}=2.384,P=0.042、0.017);随着病情严重程度增加,糖尿病占比、BMI、总胆固醇、三酰甘油、HGF水平呈升高趋势,血清ADPN水平呈下降趋势(P<0.05);ADPN是重度NAFLD发生的保护因素(P＜0.05),总胆固醇、HGF是重度NAFLD发生的危险因素(P＜0.05);血清ADPN、HGF二者联合诊断重度NAFLD的曲线下面积(AUC)均高于二者单独诊断(0.837 vs 0.674、0.728,Z_{二者联合-ADPN}=2.393、Z_{二者联合-HGF}=2.092,P=0.017、0.036)。结论: NAFLD患者血清ADPN水平下降,HGF水平升高,且ADPN、HGF水平与病情严重程度密切相关,二者联合对NAFLD及重度NAFLD具有更高的诊断价值。

Objective: To explore the value of serum adiponectin(ADPN) and hepatocyte growth factor(HGF) levels in the diagnosis and severity assessment of non-alcoholic fatty liver disease(NAFLD). Methods: A total of 100 patients with diagnosed NAFLD who came to our hospital for treatment from May 2021 to May 2023 were selected as the disease group. They were separated into severe group(n=31), moderate group(n=33), and mild group(n=36) based on the severity of condition. In addition, 100 healthy patients in our hospital were selected as the control group during the same period. Serum ADPN and HGF levels were detected by using ELISA method; Logistic regression was applied to analyze the influencing factors of severe NAFLD; ROC curve was applied to analyze the diagnostic value of serum ADPN and HGF levels for NAFLD and severe NAFLD. Results: Compared with the control group, the serum ADPN level in the diseased group obviously decreased, while the HGF level obviously increased(P<0.05). The area under the curve(AUC) of the combined diagnosis of serum ADPN and HGF for NAFLD was higher than that of the individual diagnosis(0.859 vs 0.790, 0.744, Z_{combined-ADPN}=2.033, Z_combined-HGF=2.384, P=0.042, 0.017). As the severity of the disease increased, the proportion of diabetes, BMI, total cholesterol, triacylglycerol, HGF levels showed an upward trend, and the serum ADPN level showed a downward trend(P<0.05). ADPN was a protective factor that affected the occurrence of severe NAFLD(P<0.05), while total cholesterol and HGF were risk factors that affected the occurrence of severe NAFLD(P<0.05). The area under the curve(AUC) of the combined diagnosis of serum ADPN and HGF for severe NAFLD was higher than that of the two diagnoses alone(0.837 vs 0.674, 0.728, Z_{combined-ADPN}=2.393, Z_combined-HGF=2.092, P=0.017, 0.036). Conclusion: Serum ADPN level decreases and HGF level increases in patients with NAFLD, and the levels of ADPN and HGF are closely related to the severity of condition. The combination of the two has higher diagnostic value for NAFLD and severe NAFLD.

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