血清CK18-M30及CK18-M65水平在体检人群脂肪肝筛查中的意义及脂肪肝的危险因素分析  

Significance of Serum CK18-M30 and CK18-M65 Levels in the Screening of Fatty Liver in Physical Examination Population and Analysis of Risk Factors for Fatty Liver

作　　者：张艳[1] 曹季军[1] 李晓红[1] 吴祎 ZHANG Yan;CAO Jijun;LI Xiaohong;WU Yi(Taicang First People's Hospital,Taicang 215400,China;不详)

机构地区：[1]太仓市第一人民医院,江苏太仓215400

出　　处：《中外医学研究》2023年第21期71-75,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究血清细胞角蛋白18-M30片段(CK18-M30)及细胞角蛋白18-M65片段(CK18-M65)水平在体检人群脂肪肝筛查中的意义及脂肪肝的危险因素分析。方法:选取2020年7月—2022年6月在太仓市第一人民医院进行健康体检的147例体检者作为本次研究对象。记录体检者脂肪肝的检出情况,根据其是否发生脂肪肝将其分为脂肪肝组(n=38)和无脂肪肝组(n=109),比较两组血清中CK18-M30、CK18-M65表达水平,单因素和多因素logistic回归分析影响脂肪肝发生的因素,并用受试者工作特征(ROC)曲线分析其表达水平在脂肪肝诊断中的应用价值。结果:在147例体检者中,共检查出脂肪肝患者38例,检出率为25.85%(38/147)。脂肪肝组血清中CK18-M30、CK18-M65表达水平均高于无脂肪肝组,差异有统计学意义(P<0.05)。单因素分析结果显示,两组性别、年龄、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、谷草转氨酶(AST)水平比较,差异无统计学意义(P>0.05);脂肪肝组体重指数(BMI)、腰围、合并糖尿病占比、合并高血压占比、合并高脂血症占比、谷丙转氨酶(ALT)水平均显著高于无脂肪肝组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,高BMI(OR=1.874)、高腰围(OR=2.114)、合并糖尿病(OR=2.257)、高CK18-M30(OR=2.577)、高CK18-M65(OR=1.974)是影响脂肪肝发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,CK18-M30和CK18-M65联合检测诊断脂肪肝的曲线下面积(AUC)为0.885(95%CI:0.822,0.948),明显高于CK18-M30单独检测的0.735(95%CI:0.636,0.834)和CK18-M65的0.778(95%CI:0.704,0.853)。结论:高BMI、高腰围、合并糖尿病、高CK18-M30、高CK18-M65是影响脂肪肝发生的独立危险因素,CK18-M30和CK18-M65水平在脂肪肝患者血清中呈现出异常高表达现象,临床在脂肪肝中有较好诊断效果,可作为体检人群筛查脂肪肝的有效指标。Objective:To explore the significance of serum cytokeratin 18-M30 fragment(CK18-M30)and cytokeratin 18-M65 fragment(CK18-M65)levels in screening of fatty liver in physical examination population,and analysis of risk factors for fatty liver.Method:A total of 147 physical examiners from July 2020 to June 2022 in Taicang First People's Hospital were selected as the subjects of this study.The detection of fatty liver in physical examiners was recorded,and they were divided into fatty liver group(n=38)and non fatty liver group(n=109)according to whether they had fatty liver.The expression levels of CK18-M30 and CK18-M65 in serum of the two groups were compared,the factors influencing fatty liver were analyzed by univariate and multivariate logistic regression,and the application value of their expression levels in the diagnosis of fatty liver was analyzed with receiver operating characteristic(ROC).Result:Among 147 examiners,a total of 38 patients with fatty liver were detected,with a detection rate of 25.85%(38/147).The expression levels of CK18-M30 and CK18-M65 in the serum of the fatty liver group were higher than those of the non fatty liver group,the differences were statistically significant(P<0.05).The results of univariate analysis showed that there were no significant differences in gender,age,and the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and aspartate aminotransferase(AST)between the two groups(P>0.05).The body mass index(BMI),waist circumference,the proportion of diabetes,hypertension,hyperlipidemia and alanine aminotransferase(ALT)levels in the fatty liver group were significantly higher than those in the non fatty liver group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that high BMI(OR=1.874),high waist circumference(OR=2.114),combined diabetes(OR=2.257),high CK18-M30(OR=2.577),and high CK18-M65(OR=1.974)were independent risk factors for fatty liver(P<0.05).The results of ROC analysis showed that the area under the cur

关 键 词：体检人群 脂肪肝筛查 细胞角蛋白18-M30片段 细胞角蛋白18-M65片段 

分 类 号：R575.5[医药卫生—消化系统]