血清骨桥蛋白与非酒精性脂肪性肝病患者肝纤维化的相关性分析  

Correlation analysis of serum osteopontin and liver fibrosis in non-alcoholic fatty liver disease patients

作　　者：钱念东[1] 黄萍[1] 齐进[1] 邓廉夫[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院上海市伤骨科研究所上海市中西医结合防治骨与关节病损重点实验室,上海200025

出　　处：《检验医学》2014年第11期1154-1157,共4页Laboratory Medicine

摘　　要：目的探讨血清骨桥蛋白(OPN)水平在非酒精性脂肪性肝病(NAFLD)肝纤维化诊断中的价值。方法选择手术临床确诊NAFLD患者86例、健康对照者(正常对照组)60名。采用肝组织活检评估肝纤维化分期,酶联免疫吸附试验(ELISA)检测血清OPN水平,并与患者临床生化指标[包括丙氨酸氨基转移酶(AST)、天门冬氨酸氨基转移酶(ALT)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)与高敏C反应蛋白(hs-CRP)]进行相关分析。结果与正常对照组相比,NAFLD组的体重指数(BMI)、收缩压、舒张压、AST、ALT、稳态胰岛素评价指数(HOMA-IR)、TC、LDL-C及TG均明显增高,且罹患糖尿病、代谢综合征比例较高(P<0.01);NAFLD组血清OPN水平较明显高于正常对照组,且与AST、ALT、hs-CRP、肝纤维化分期呈正相关(r值分别为0.224、0.265、0.192、0.219,P值分别为<0.001、<0.001、0.003、<0.001),与性别、HDL-C呈负相关(r值分别为-0.213、-0.191,P值分别为<0.01、0.041)。受试者工作特征(ROC)曲线显示当OPN以32μg/L作为临界值时,诊断肝纤维化≥3期NAFLD的曲线下面积(AUC)为0.897,灵敏度和特异性分别为0.821和0.855。结论作为促纤维化因子,OPN不仅可以反映NAFLD的纤维化程度,而且在NAFLD病变形成中也可能起到一定作用。Objective To investigate the significance of serum osteopontin （OPN）level in the diagnosis of liver fibrosis in non-alcoholic fatty liver disease （NAFLD）.Methods A total of 86 NAFLD patients and 60 healthy controls （healthy control group）were enrolled.Liver biopsy was carried out in NAFLD patients to evaluate liver fibrosis stages. Enzyme-linked immunosorbent assay （ELISA）was used to detect serum levels of OPN in NAFLD patients and healthy controls,and the correlations of OPN level with aspartate aminotransferase （AST）,alanine aminotransferase （ALT）, total cholesterol （TC）,high-density lipoprotein cholesterol （HDL-C）,low-density lipoprotein cholesterol （LDL-C）, triglyceride （TG）and high-sensitivity C reaction protein （hs-CRP）were analyzed.Results Compared with healthy controls,body mass index（BMI）,systolic pressure,diastolic pressure,AST,ALT,homeostasis model assessment for insulin resistance （HOMA-IR）,TC,LDL-C and TG in NAFLD patients significantly increased,and the proportion of diabetes mellitus and metabolism syndrome was higher （P ＆lt;0.01 ）.Serum OPN level was significantly higher in NAFLD patients and showed positive correlation with AST,ALT,hs-CRP and liver fibrosis stages （r =0.224,0.265,0.1 92 and 0.21 9,P ＆lt;0.001 ,＆lt;0.001 ,=0.003 and ＆lt;0.001 ,respectively）.There were negative correlations with sex and HDL-C （r =-0.21 3 and -0.1 91 ,P ＆lt;0.01 and =0.041 ,respectively）.In addition,for liver fibrosis stage ≥3 in NAFLD patients,when the cut-off value was 32μg/L,the area under receiver operating characteristic （ROC）curve was 0.897,and the sensitivity and specificity were 0.821 and 0.855.Conclusions As a pro-fibrotic factor,OPN can not only predict NAFLD fibrosis stages,but also plays a role in pathogenesis of NAFLD.

关 键 词：骨桥蛋白 非酒精性脂肪性肝病 肝纤维化 

分 类 号：R446.1[医药卫生—诊断学]