血清TXNIP在非酒精性脂肪性肝病中的临床意义

The clinical value of serum TXNIP in non-alcoholic fatty liver disease

目的检测非酒精性脂肪性肝病（non-alcoholic fatty liver disease,NAFLD）患者血清硫氧还蛋白结合蛋白（thioredoxin-interacting protein,TXNIP）浓度水平,探讨TXNIP在NAFLD中的临床意义。方法用酶联免疫吸附法（ELISA）检测134例NAFLD患者及100名健康对照者血清TXNIP水平,同时收集血糖、血脂等一般资料。结果 NAFLD组血清TXNIP浓度明显高于对照组[（423.94±63.46）pg/ml vs（246.74±83.63）pg/ml,P=0.000];脂肪肝炎组血清TXNIP浓度明显高于单纯性脂肪肝组[（473.30±54.48）pg/ml vs（396.84±65.15）pg/ml,P=0.000]。相关分析表明TXNIP与MDA（r=0.257,P=0.006）、hs-CRP（r=0.178,P=0.018）、TNF-α（r=0.245,P=0.005）、HOMA-IR（r=0.214,P=0.001）呈正相关,但与HDL-c（r=-0.184,P=0.027）、GSH（r=-0.358,P=0.000）呈负相关。多重线性回归分析提示MDA、HOMA-IR是影响TXNIP水平的独立相关因素,血清TXNIP诊断NAFLD和脂肪肝炎ROC曲线下面积为0.957（0.933-0.980）和0.832（0.755-0.909）。结论血清TXNIP与胰岛素抵抗、氧化应激密切相关,有助于NAFLD诊断及病情检测。

Objective To detect the serum levels of thioredoxin-interacting protein（TXNIP） in patients with nonalcoholic fatty liver disease（ NAFLD）,and to analyze the clinical value of TXNIP in NAFLD. Methods Enzyme linked immunosorbent assay（ ELISA） was used to detect the serum TXNIP in 134 patients with NAFLD and 100 healthy controls. Blood glucose,blood lipids and other general information were analyzed. Results The serum TXNIP concentration in NAFLD patients was significantly higher than that in the healthy controls [（ 423. 94 ± 63. 46） pg / ml vs（246. 74 ± 83. 63） pg /ml,P = 0. 000]. The concentration in non-alcoholic steatohepatitis（NASH） patients was also higer than that in simple fatty liver（SFL） patients [（473. 30 ± 54. 48） pg / ml vs（396. 84 ± 65. 15） pg / ml,P = 0. 000].TXNIP associated positively with MDA（ r = 0. 257,P = 0. 006）,hs-CRP（ r = 0. 178,P = 0. 018）,TNF-α（ r = 0. 245,P = 0. 005）,HOMA-IR（ r = 0. 214,P = 0. 001）,but associated negatively with HDL-c（ r =- 0. 184,P = 0. 027）,GSH（ r =- 0. 358,P = 0. 000）. The areas under the ROC curve of TXNIP in the diagnosis of NFLAD and NASH were0. 957（0. 933-0. 980） and 0. 832（0. 755-0. 909）. Conclusion TXNIP is closely related to oxidative stress and insulin resistance in NAFLD. It is useful for disease surveillance and diagnosis of NAFLD by serum TXNIP.