肝硬化患者血清网膜素、脂联素的表达及其相关性分析  

Correlation analysis and clinical significance of serum omentin and adiponectin in patients with liver cirrhosis

作　　者：魏新亮[1] 魏思忱[1] 田树英[1] 孔郁[1] 王卫卫[1] 姜红玉[1] 

机构地区：[1]沧州市中心医院消化内二科,河北沧州061001

出　　处：《临床荟萃》2016年第12期1313-1317,共5页Clinical Focus

基　　金：河北省沧州市科学技术研究与发展指导计划项目(141302056)

摘　　要：目的测定肝硬化患者血清网膜素、脂联素水平,分析其与胰岛素、Child-Pugh分级及肝脏生化指标及血脂间的关系。方法选择住院的肝硬化患者(肝硬化组)97例,Child-Pugh分级A级33例、B级32例、C级32例;健康体检者(对照组)32例,分析其血清网膜素、脂联素及相关的临床生化参数变化特点。结果肝硬化组血清网膜素、脂联素水平明显高于对照组(P<0.05),肝硬化组内A、B、C 3级间网膜素、脂联素水平差异无统计学意义(P>0.05),肝硬化组血清网膜素、脂联素水平与HOMA-IR、胰岛素水平无明显相关性(r=-0.135,P=0.277,r=-0.171,P=0.166;r=-0.194,P=0.115,r=-0.102,P=0.401),网膜素水平与脂联素、白蛋白呈正相关(r=0.447,P=0.00;r=0.225,P=0.037),脂联素水平与HOMA-IR、胰岛素水平无明显相关性,与高密度脂蛋白胆固醇(HDL-C)正相关(r=0.264,P=0.036),与凝血酶原时间负相关(r=-0.306,P=0.014)。血清网膜素、脂联素预测肝硬化ROC曲线下面积为0.761、0.918的cutoff分别为905.18ng/L,763.85μg/L,脂联素诊断价值更高。结论肝硬化时网膜素、脂联素升高,可作为预测肝硬化的指标,但不能作为评估肝功能严重程度的指标。Objective To investigate the the relationship between the serum omentin,adiponectin levels in liver cirrhosis patients and the insulin,Child-Pugh grade,liver biochemical indexes and serum lipids.Methods Ninty-seven patients with liver cirrhosis（A33,B32 and C32）patients and 32 cases of healthy controls were enrolled.Serum omentin,serum adiponectin and related clinical and biochemical parameters were observed in two groups.Results The serum omentin and serum adiponectin levels in patients with liver cirrhosis were higher than those of healthy control group（P 0.05）.The omentin and adiponectin level showed no significant difference in A,B and C grade of liver cirrhosis group（P 0.05）.There were no obvious correlation between serum omentin,adiponectin levels and HOMA-IR,insulin levels in liver cirrhosis patients（r=-0.135,P =0.277,r=-0.171,P =0.166;r=-0.194,P=0.115,r=-0.102,P =0.401）.The level of omentin was positively correlated with adiponectin and albumin（r =0.447,P =0.00;r =0.225,P =0.037）.And the level of adiponectin was positively correlated with high-density lipoprotein（r =0.264,P =0.036）,but negtively correlated with prothrombin time（r =-0.306,P =0.014）.The areas under the ROC curves of omentin and adiponectin were 0.761 and 0.918,rspectively and the cutoff values for liver cirrhosis prediction were 905.18ng/L and 763.85μg/L.And the adiponectin had higher sensitivity for the diagnostic value.Conclusion The omentin and adiponectin can be used as prediction indexes of liver cirrhosis,but not be used to evaluate the severity of liver function in liver cirrhosis.

关 键 词：肝硬化 网膜素 脂联素 CHILD-PUGH分级 胰岛素抵抗 

分 类 号：R575.2[医药卫生—消化系统]