非酒精性脂肪性肝病患者血清Chemerin和颈动脉内膜中层厚度的相关性

Association of serum Chemerin levels and carotid intima-media thickness in patients with nonalcoholic fatty liver disease

目的探讨非酒精性脂肪性肝病(NAFLD)患者血清Chemerin和颈动脉内膜中层厚度(CIMT)的相关性。方法回顾性纳入2019年1月1日至2020年5月1日于新乡医学院第一附属医院就诊的96例NAFLD患者和体检中心35例健康体检者,其中NAFLD患者CIMT≥1.0 mm定义为ACIMT组,CIMT<1.0 mm定义为NCIMT组,健康体检者定义为对照组。比较三组研究对象性别、年龄、BMI、吸烟史、合并糖尿病病史、高血压病史、收缩压、舒张压、FBG、TC、TG、HDL-c、LDL-c、HbA1c、FPG、FINS、HOMA-IR、ALT、AST、UA、Chemerin和CIMT的差异,相关性分析采用Pearson分析,NAFLD患者IMT的危险因素采用Logistic回归分析,血清Chemerin水平诊断NAFLD患者IMT≥1.0 mm的临床效能采用ROC曲线评估。结果TG、LDL-c、FINS、HOMA-IR、ALT、AST、Chemerin在对照组、NCIMT组和ACIMT组中依次升高,组组比较均存在显著差异(P<0.05);FPG、UA和CIMT在对照组和NCIMT组中相比较均无显著差异(P>0.05);与对照组和NCIMT组相比较,ACIMT组中FPG、UA和CIMT均显著升高(P<0.05)。NAFLD患者CIMT水平与TG、LDL-c、HOMA-IR、UA和Chemerin均呈现显著正相关性,相关系数分别为0.322、0.474、0.354、0.365和0.489。Logistic回归分析显示,TG(OR=4.221)、HOMA-IR(OR=1.353)、LDL-c(OR=5.548)和Chemerin(OR=8.015)是NAFLD患者CIMT的危险因素。血清中Chemerin表达水平诊断NAFLD患者CIMT≥1.0 mm的曲线下面积为0.885(95%CI:0.813~0.942,P<0.000),当截断值为265.29 ng/mL时,诊断敏感度和特异度分别为93.24%和95.25%。结论Chemerin是NAFLD患者CIMT增厚的一项危险因素,其可作为临床上检测NAFLD患者颈动脉粥样硬化的一项生物学标志物。

Objective To explore the association of serum Chemerin levels and carotid intima-media thickness in patients with Nonalcoholic fatty liver disease(NAFLD).Methods A total of 96 patients with NAFLD,35 healthy individuals(control group)were enrolled in our hospital between January 1st 2019 and May 1st 2020.When CIMT≥1.0mm were defined as ACIMT group and others were defined as NCIMT group according to the carotid intima-media thickness(CIMT)of 96 patients with NAFLD.The differences of sex,age,BMI,smoking history,history of diabetes mellitus,history of hypertension,systolic blood pressure,diastolic blood pressure,FBG,TC,TG,HDL-c,LDL-c,HbA1c,FPG,Fins,HOMA-IR,ALT,AST,UA,Chemerin and CMIT were detected and compared among the three groups.Pearson analysis was used for correlation analysis.The risk factors of CIMT in patients with NAFLD were analyzed by logistic regression analysis.The clinical efficacy of serum Chemerin levels in the evaluating the CIMT≥1.0 mm,patients with NAFLD was analyzed by ROC curve.Results Serum levels of TG,LDL-c,FINS,ALT,AST,Chemerin and HOMA-IR in the control group,NCIMT group and ACIMT group increased gradually and there was significant difference between each group(P<0.05).There was no significant difference in serum FPG,UA levels and CIMT between the control group and NCIMT group(P>0.05).When compared with the control group and NCIMT group,serum FPG,UA levels and CIMT were significantly higher in ACIMT group(P<0.05).There was a significant positive correlation between CIMT levels and TG,LDL-C,HOMA-IR,UA and Chemerin in NAFLD patients.The correlation coefficients were 0.322,0.474,0.354,0.365 and 0.489,respectively.Logistic regression analysis showed that TG(OR=4.221),HOMA-IR(OR=1.353),LDL-c(OR=5.548)and Chemerin(OR=8.015)were risk factors of CIMT in patients with NAFLD.The AUC of Chemerin in the diagnosis of CIMT≥1.0 mm in patients with NAFLD was 0.885(95%CI:0.813~0.942,P<0.000).When the cut-off value was 265.29 ng/mL,the sensitivity and specificity was 93.24%and 95.25%,respectively.Conclusion Chemerin is a risk factor of CIMT thickening and it can be used as a biomarker to detect carotid atherosclerosis in patients with NAFLD.