血清AMPK-αmRNA、Caspase-6 mRNA水平对非酒精性脂肪肝疗效的预测价值及影响因素分析  

Predictive value and influencing factors of serum AMPK-αmRNA and Caspase-6 mRNA levels in therapeutic efficacy of non-alcoholic fatty liver disease (NAFLD)

作　　者：刘春华[1] 马丽敏 刘凤华[1] 刘英果 LIU Chunhua;MA Limin;LIU Fenghua;LIU Yingguo(Infectious Diseases Department,Liaocheng People′s Hospital,Liaocheng Shandong 252000,China;Infectious Diseases Department,Liaocheng Infectious Diseases Hospital,Liaocheng Shandong 252000,China)

机构地区：[1]聊城市人民医院感染性疾病科,山东聊城252000 [2]聊城市传染病医院感染性疾病科,山东聊城252000

出　　处：《新疆医科大学学报》2024年第7期1001-1007,共7页Journal of Xinjiang Medical University

基　　金：山东省医药卫生科技发展计划项目(2022WH173-02)。

摘　　要：目的 分析血清腺苷酸活化蛋白激酶-αmRNA(Adenosine monophosphate activated protein kinase α,AMPK-αmRNA)、半胱氨酸天冬氨酸蛋白酶-6(Cystein-asparate protease,caspase-6) mRNA水平对非酒精性脂肪肝(Non-alcoholic fatty liver disease,NAFLD)疗效的预测价值及影响因素。方法 选取2021年10月-2023年8月聊城市人民医院感染性疾病科收治的188例NAFLD患者为研究对象,治疗6个月后以甘油三酯(TG)降低≥20%和(或)总胆固醇(TC)降低≥10%判断为治疗有效,归入有效组,否则判断为治疗无效,归入无效组。所有患者治疗前后检测血清AMPK-αmRNA、Caspase-6 mRNA水平。收集NAFLD患者一般资料,分析NAFLD疗效的影响因素。绘制受试者工作特征(Receiver operating characteristic curve,ROC)曲线分析血清AMPK-αmRNA,Caspase-6 mRNA水平对NAFLD疗效的预测价值。结果 188例NAFLD患者治疗6个月脱落6例,有效随访182例,其中治疗有效126例(69.23%),纳入有效组,治疗无效56例(30.77%),纳入无效组。与本组治疗前比较,治疗6个月后患者血清AMPK-αmRNA水平升高,Caspase-6 mRNA水平降低,差异有统计学意义(P<0.05)。与无效组比较,有效组治疗前、治疗6个月血清AMPK-αmRNA水平升高,Caspase-6 mRNA水平降低,差异有统计学意义(P<0.05)。患有糖尿病,血清TC、TG、低密度脂蛋白胆固醇(Low-density lipoprotein,LDL-C)、谷丙转氨酶(Alanime aminotransferase,ALT)、谷草转氨酶(Aspartate aminotransferase,AST),Caspase-6 mRNA水平是NAFLD疗效的独立危险因素,治疗前血清AMPK-αmRNA水平是其独立保护因素(P<0.05)。建立Logistic回归模型:logit(P)=-29.182-0.867×AMPK-αmRNA+0.890×Caspase-6 mRNA+1.956×糖尿病+1.283×TG+0.982×TC+0.703×LDL-C+0.066×ALT+0.101×AST,拟合度较好。治疗前血清AMPK-αmRNA、Caspase-6 mRNA水平及Logistic回归模型预测NAFLD疗效的曲线下面积(Area under curve,AUC)值分别为0.757、0.717、0.816,Logistic回归模型的预测价值大于AMPK-αmRNA,Caspase-6 mRNA�Objective To analyze the predictive value and influencing factors of serum adenosine monophosphate activated protein kinase alpha(AMPK-α mRNA) and caspase-6 mRNA levels on the efficacy of non-alcoholic fatty liver disease(NAFLD).Methods 188 NAFLD patients admitted to the hospital from October 2021 to August 2023 were selected as study subjects.After 6 months of thetreatment,the treatment was judged to be effective if the triglyceride(TG) wasdecreased by ≥ 20% and/or the total cholesterol(TC) wasdecreased by ≥ 10%,and they were classified into the effective group.Otherwise,the treatment was judged to be ineffective and they were classified into ineffective group.All patients were tested for serum AMPK-α mRNA and Caspase-6 mRNA levels before and after the treatment.Collected general information of NAFLD patients and analyzed the influencing factors of NAFLD efficacy.Receiver operating characteristic curve(ROC) curvewas drawnto analyze the predictive value of serum AMPK-α mRNA and Caspase-6 mRNA levels on the efficacy of NAFLD.Results Of 188 cases,6 cases fell off after 6 months of thetreatment,182 cases were effectively followed up,of which 126 cases(69.23%) were effective and included in the effective group,and 56 cases(30.77%) were found to be ineffective in treatment and wereincluded in the ineffective group.Compared with before the treatment in the same group,the serum AMPK-αmRNA level wasincreased significantly,while the Caspase-6 mRNA level was decreased significantly after 6 months of the treatment,with a statistically significant difference(P<0.05).Compared with the ineffective group,the serum AMPK-αmRNA level in the effective group was significantly increased before the treatment and after 6 months of thetreatment,while the Caspase-6 mRNA level was significantly decreased(P<0.05).Diabetes,serum TC,TG,low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST) and Caspase-6 mRNA levels were independent risk factors for the therapeutic effect of NAFLD,whi

关 键 词：非酒精性脂肪肝 影响因素 腺苷酸活化蛋白激酶-α 微小核糖核酸 半胱氨酸天冬氨酸蛋白酶-6 

分 类 号：R575[医药卫生—消化系统]