Obestatin与Ghrelin在炎症性肠病中的表达及临床价值

Expression and clinical significance of Obestatin and Ghrelin in patients with inflammatory bowel disease

目的研究炎症性肠病患者血浆Obestatin和Ghrelin的表达水平,分析血浆Obestatin和Ghrelin表达水平对炎症性肠病的诊断和鉴别意义。方法应用酶联免疫吸附试验(Enzyme-linked immune-sorbent assay,ELISA)对克罗恩病患者、溃疡性结肠炎患者和正常对照者血浆中Obestatin及Ghrelin的表达进行分析。通过受试者工作特征曲线(receiver-operating characteristic,ROC)观察血浆Obestatin、Ghrelin水平及Obestatin/Ghrelin比值在克罗恩病和溃疡性结肠炎的诊断和鉴别价值,数据处理使用GraphPad Prism 5。结果溃疡性结肠炎患者(P<0.0001)和克罗恩病患者(P=0.0001)血浆Obestatin水平均显著高于正常对照者,并且溃疡性结肠炎患者血浆Obestatin水平显著高于克罗恩病患者(P=0.0003)。溃疡性结肠炎患者(P=0.0279)和克罗恩病患者(P=0.0192)血浆Ghrelin水平均显著高于正常对照者,但是溃疡性结肠炎患者和克罗恩病患者间血浆Ghrelin水平无显著性差异(P=0.9331)。溃疡性结肠炎患者血浆Ghrelin/Obestatin比值显著低于正常对照者(P=0.0487),但是克罗恩病患者血浆Ghrelin/Obestatin比值与溃疡性结肠炎患者(P=0.1076)和正常对照者(P=0.8136)无显著性差异。血浆Obestatin水平对于区分溃疡性结肠炎患者和正常对照者(AUC=0.8791,P<0.0001)、克罗恩病患者和正常对照者(AUC=0.7317,P=0.0001)以及溃疡性结肠炎和克罗恩病患者(AUC=0.7340,P=0.0001)具有显著的鉴别诊断价值。血浆Ghrelin水平对于区分克罗恩病患者和正常对照者具有显著的诊断价值(AUC=0.6660,P=0.0059)。但是,血浆Ghrelin/Obestatin比值对于区分溃疡性结肠炎和正常对照者无显著的鉴别诊断价值(AUC=0.5608,P=0.2923)。结论溃疡性结肠炎和克罗恩病患者血浆Obestatin及Ghrelin水平增高,综合评估溃疡性结肠炎和克罗恩病患者血浆Obestatin、Ghrelin以及Ghrelin/Obestatin比值对疾病的诊断和鉴别有一定意义。

Objective To investigate plasma levels of Obestatin and Ghrelin in patients with inflammatory bowel disease and to analyze diagnostic and differential significance of Obestatin and Ghrelin in patients with inflammatory bowel disease. Methods Enzyme-linked immuno-sorbent assay （ELISA） was applied to analyze plasma expression of Obestatin and Ghrelin in patients with Crohn＇ s disease, Ulcerative colitis and healthy controls. Receiver operating characteristic curve （ROC） was used to observe diagnostic and differential value of plasma Obestatin, Ghrelin levels and Obestatin/Ghrelin Ratio in patients with Crohn＇ s disease and Ulcerative colitis. Data was analyzed with GraphPad Prism 5. Results Plasma levels of Obestatin were significant higher in patients with ulcerative colitis （ P 〈 0. 0001 ） and Crohn＇ s disease （P = 0. 0001 ） than that in healthy controls. And plasma levels of Obestatin were significantly higher in patients with ulcerative colitis than that in patients with Crohn＇ s disease （P = 0. 0003 ）. Plasma levels of Ghrelin were significantly higher in patients with Ulcerative colitis （P = 0. 0279） and Crohn＇ s disease （P = 0. 0192） than that in healthy controls. However, there was no significant difference of plasma levels of Ghrelin in patients with ulcerative colitis and in patients with Crohn＇ s disease （P = 0. 9331 ）. Moreover, plasma Ghrelin/Obestatin ratio was significant lower in pa- tients with ulcerative colitis than that in healthy controls （P = 0. 0487）. However, plasma Ghrelin/Obestatin ratio showed no significant difference in patients with Crohn＇ s disease than that in patients with ulcerative colitis （P = 0. 1076） or healthy controls （P = 0. 8136）. Plasma level of Obestatin showed significantly differential value in distinguishing patients with ulcerative colitis and healthy controls （AUC =0. 8791, P 〈0. 0001 ）, patients with Crohn＇ s dis-ease and healthy controls （AUC = 0. 7317, P = 0. 0001 ） , or patients with ulcerative colitis and Crohn＇ s disease （AUC =0. 7340, P =0. 0001 ）. Furthermore, plasma levels of Ghrelin showed significantly diagnostic value in distinguishing patients with Crohn＇ s disease and healthy controls （AUC = 0. 6660, P = 0. 0059）. However, plasma Ghrelin/Obestatin ratio showed no significantly differential value in distinguishing patients with ulcerative colitis and healthy controls （AUC = 0. 5608, P = 0. 2923）. Conclusion Plasma levels of Obestatin and Ghrelin increase in patients with ulcerative colitis and Crohn＇ s disease. Comprehensive assessment of plasma Obestatin, Ghrelin and Ghrelin/Obestatin ratio in patients with ulcerative colitis and Crohn＇ s disease show certain value in diagnosis and differentiation.