2型糖尿病合并非酒精性脂肪肝患者GP73水平的检测及临床意义

目的探讨血清高尔基体蛋白73(GP73)作为判断2型糖尿病(T2DM)是否合并非酒精性脂肪肝(NAFLD)的临床应用价值。方法选取NAFLD患者122例,初治T2DM患者30例,T2DM合并NAFLD患者41例及健康体检者33例,采用酶联免疫吸附法定量检测患者血清中GP73水平,生化分析仪检测各肝功能指标,应用肝脏瞬时弹性检测仪检测其受控衰减参数(CAP)和E值,并分析血清GP73含量与上述指标的关系,ROC曲线分析GP73诊断NAFLD的效能。结果与单纯T2DM组(38.13±28.50)ng/ml及健康对照组(46.22±19.01)ng/ml相比,NAFLD患者组(76.19±41.38)ng/ml及T2DM合并NAFLD患者组(73.36±42.00)ng/ml血清GP73水平显著升高,差异有统计学意义(P<0.05)。以健康体检组及T2DM组为对照,GP73诊断NAFLD的ROC曲线下面积为0.792(95%CI:0.733~0.843,P<0.0001),以59.22ng/ml作为cut-off值,GP73诊断NAFLD的特异性和敏感性分别为82.54%为69.94%。血清GP73与ALT、AST、GGT、CAP、E值均呈正相关(r分别为0.221,0.152,0.232,0.214,0.285)。结论GP73可作为T2DM是否合并NAFLD及其发生肝细胞脂肪变与肝纤维化的潜在指标。

Objective To investigate the clinical application value of serum Golgi protein 73(GP73)in judging whether type 2 diabetes mellitus(T2DM)is complicated with nonalcoholic fatty liver(NAFLD).Methods 122 patients with NAFLD,30 patients with newly diagnosed T2DM,41 patients with T2DM combined with NAFLD and 33 healthy people were selected.Enzyme linked immunosorbent assay(ELISA)was used to quantitatively detect the serum GP73 level of patients,biochemical analyzer was used to detect various liver function indexes,and liver transient elasticity detector was used to detect its controlled attenuation parameters(CAP)and E values.And the relationship between serum GP73 content and the above indexes was analyzed.ROC curve was used to analyze GP73 as the diagnostic efficiency of NAFLD.Results Compared with T2DM group(38.13±28.50ng/ml)and healthy control group(46.22±19.01ng/ml),serum GP73 levels in NAFLD group(76.19±41.38ng/ml)and T2DM combined with NAFLD group(73.36±42.00ng/ml)were significantly higher,and there was significant statistically differences between two groups(P<0.05).The area under ROC curve for GP73 diagnosis of NAFLD was 0.792(95%CI:0.733~0.843,P<0.0001)and 59.22ng/ml was taken as cut-off value.The specificity and sensitivity of GP73 diagnosis of NAFLD were 82.54%and 69.94%,respectively.Serum GP73 was positively correlated with ALT,AST,GGT,CAP and E(r=0.221,0.152,0.232,0.214,0.285,respectively).Conclusion GP73 may be a potential indicator of whether T2DM with NAFLD or not and as a potential marker of hepatic steatosis and hepatic fibrosis in T2DM.