非肥胖非酒精性脂肪性肝病与细胞角蛋白18相关性研究及危险因素分析

Relationship between cytokeratin 18 and non obese nonalcoholic fatty liver disease and its risk factors

目的探讨细胞角蛋白在非肥胖非酒精性脂肪性肝病(NAFLD)中的诊断价值及分析非肥胖非酒精性脂肪性肝病危险因素,以期为非肥胖NAFLD临床诊断和防治提供依据。方法选择2019年1—6月在本院就诊的非肥胖NAFLD患者20例、肥胖NAFLD患者20例、健康体检者20名和代谢正常肥胖者20名作为研究对象,用酶联免疫吸附法检测血清中细胞角蛋白18(CK-18)水平,同时采集四组患者个人史,检测血清中肝功能、空腹血糖。方差分析、t检验分析四组相关指标水平差异,危险因素分析采用多因素logistics回归分析。结果非肥胖NAFLD组、肥胖NAFLD组、健康对照组、代谢正常肥胖对照组AST、ALT、总胆红素、直接胆红素、球蛋白,存在统计学差异(P<0.05)。总胆红素、球蛋白是影响非肥胖NAFLD发生的独立危险因素(OR值分别为1.22、1.33)。非肥胖NAFLD组和肥胖NAFLD组血清CK-18水平均高于健康对照组、代谢正常肥胖对照组,差异均有统计学意义(P<0.05);非肥胖NAFLD组血清CK-18水平明显高于肥胖NAFLD组,差异有统计学意义(P<0.05)。结论非肥胖NAFLD与肝功能异常密切相关;血清CK-18对诊断非肥胖NAFLD有一定价值。

Objective To explore the diagnostic value of cytokeratin in non-obese non-alcoholic fatty liver disease(NAFLD)and to analyze the risk factors of non-obese non-alcoholic fatty liver disease,in order to provide the basis for the diagnosis and treatment of non-obese NAFLD.Methods From January to June 2019,20 cases of non-obese NAFLD,20 cases of obese NAFLD,20 cases of healthy people received examination and 20 cases of obese patients with normal metabolism were selected as study subjects.Enzyme linked immunosorbent assay was used to detect levels of cytokeratin 18(CK-18)in serum.At the same time,the personal history of the four groups were collected.Liver function and fasting blood glucose were detected.Analysis of variance,t-test analysis were used to analyze the related indicators level of the four groups,risk factor analysis was conducted by using multivariate logistics regression analysis.Results The levels of AST,ALT,total bilirubin,direct bilirubin and globulin were statistically different among the non-obese NALFD group,obesity NALFD group,healthy control group,normal metabolic obesity control group,(P<0.05).Total bilirubin and globulin were independent risk factors for non-obesity NALFD(OR values were 1.22,1.33,respectively).The serum CK-18 levels of non-obese NALFD group and obese NALFD group were higher than those of healthy control group and normal metabolic obesity control group,all differences were statistically significant(P<0.05).The serum CK-18 level in non-obese NALFD group was significantly higher than that in obese NALFD group,the difference was statistically significant(P<0.05).Conclusions Non-obese NALFD is closely related to abnormal liver function;Serum CK-18 has certain value in the diagnosis of non-obese NALFD.