脂联素基因检测和血清标志物GDF15、GPC4与MAFLD的相关性研究  

Correlation between APN gene detection and serum markers GDF15,GPC4 and MAFLD

作　　者：滑劲咏[1] 曹砚杰 李清楚[3] 刘静 丁玫 赵贺敏 贾小涵 HUA Jin-yong;CAO Yan-jie;LI Qing-chu;LIU Jing;DING Mei;ZHAO He-min;JIA Xiao-han(Clinical Laboratory of Xinzheng Branch of Zhengzhou Central Hospital,Xinzheng Public People's Hospital,Zhengzhou 450007,China;Department of Gastroenterology,Zhengzhou Central Hospital,Zhengzhou 450007,China;Department of Endocrinology,Zhengzhou Central Hospital,Zhengzhou 450007,China;Clinical Laboratory,Xinzheng Public People's Hospital,Zhengzhou 450000,China;Department of Ultrasound,Xinzheng Public People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市中心医院新郑分院,新郑市公立人民医院检验科,郑州450007 [2]郑州市中心医院消化内科,郑州450007 [3]郑州市中心医院内分泌科,郑州450007 [4]新郑市公立人民医院检验科,郑州1450000 [5]新郑市公立人民医院超声科,郑州450000

出　　处：《医药论坛杂志》2024年第15期1642-1646,共5页Journal of Medical Forum

基　　金：河南省科技攻关计划联合共建项目(LHGJ20210798)。

摘　　要：目的探讨脂联素ADIPOQ基因编码位点rs2241766的基因型以及脂联(adiponectin,APN)TGF-β超家族应激反应细胞因子15(TGF-βsuperfamily stress response cytokine 15,GDF15)、血清标志物脂肪细胞因子4(serum marker adipokine 4,GPC4)等生物标志物水平与代谢相关性脂肪性肝病(metabolically associated fatty liver disease,MAFLD)的发病及鉴别诊断的相关性。方法收集2022年6月至2023年7月新郑市公立人民医院体检科健康人群以及门诊和住院患者195例,其中MAFLD患者组50例,年龄(52.87±13.09)岁;健康对照组45例,年龄(48.40±18.66)岁。2型糖尿病患者60例,年龄(53.15±17.26)岁;高血压患者40例,年龄(57.32±14.03)岁。采用东芝TBA2-000FR全自动生化分析仪对GPC4、GDF15、APN等多项血清生化指标进行检测,美国ABIVerity 96well PCR对纳入样本进行ADIPOQ rs2241766基因型检测。结果在健康人群与MAFLD患者中,携带APN rs2241766T/G+T/T基因型和G等位基因的MAFLD患者与发生MAFLD的风险显著相关(OR=0.27,95%CI:1.2-8.7,P=0.006)(OR=0.28,95%CI:1.7-11.1,P=0.001)。APN、GDF15水平在各组间比较显示:(1)APN检测结果在各组间结果的比较:MAFLD组与对照组比较,差异有统计学意义(P=0.0026),MAFLD组与高血压组比较,差异有统计学意义(P=0.013);(2)GDF15检测结果在MAFLD组与糖尿病组间比较,差异有统计学意义(P=0.017);(3)GPC4各组之间比较,差异均无统计学意义(P>0.05)。结论ADIPOQ rs2241766 T/G+T/T基因型与MAFLD患者中低APN水平相关,循环中APN水平下降是MAFLD发生的主要风险因素。GDF15可作为MAFLD患者与糖尿病人群鉴别诊断的重要指标。Objective To investigate the genotype and adiponectin(APN)encoding site rs2241766 of ADIPOQ gene.TGF-β superfamily stress response cytokine 15(GDF15),serum marker adipokine 4(GPC4),et al Correlation between biomarker levels and the onset and differential diagnosis of metabolically associated fatty liver disease(MAFLD).Methods Totally 195 outpatients and inpatients and healthy people in the physical examination department of Xinzheng Public People's Hospital from June 2022 to July 2023 were collected.Among them,50 patients in the MAFLD group,aged(52.87±13.09)years;In the control group was 45 patients,aged(48.40±18.66)years;and 60 patients of type 2 glycosuria disease,aged(53.15±17.26)years;40 patients with hypertension,aged(57.32±14.03)years.Toshiba TBA2-000FR automatic biochemical analyzer was used to detect a number of serum biochemical indexes such as GPC4,GDF15 and APN,and ABI Verity 96well PCR was used to detect ADIPOQ rs2241766 genotype of the included samples.Results Among healthy people and MAFLD patients,MAFLD patients with APN rs2241766T/G+T/T genotype and G allele were significantly associated with the risk of developing MAFLD(OR=0.27,95%CI:1.2-8.7,P=0.006)(OR=0.28,95%CI:1.7-11.1,P=0.001).The APN and GDF15 levels were compared among all groups.(1)Comparison of APN results among all groups:there was a statistically significant difference between the MAFLD group and the control group(P=0.0026),and a statistically significant difference between the MAFLD group and the hypertension group(P=0.013);(2)There was significant difference in GDF15 between the MAFLD group and the diabetes group(P=0.017).(3)There was no significant difference in GPC4 among all groups(P>0.05).Conclusion ADIPOQ rs2241766T/G+T/T genotype is associated with low APN level in patients with MAFLD,and decreased APN level in circulation is a major risk factor for MAFLD.GDF15 can be used as an important marker in the differential diagnosis of MAFLD patients and diabetic population.

关 键 词：代谢相关性脂肪性肝病 脂联素 血清标志物脂肪细胞因子4 TGF-β超家族应激反应细胞因子15 

分 类 号：R575[医药卫生—消化系统]