血清miR-221与催乳素水平对老年非酒精性脂肪性肝病的早期诊断价值研究

The value of serum miR-221 and prolactin levels in the early diagnosis of non-alcoholic fatty liver disease in the elderly

目的探讨血清miR-221和催乳素水平对老年非酒精性脂肪性肝病(NAFLD)的早期诊断价值。方法招募解放军总医院2019年1月至2019年12月经肝脏活检诊断为非酒精性脂肪性肝病的老年患者65例,其中单纯非酒精性脂肪变性(SNAFL)组40例,非酒精性脂肪性肝炎(NASH)组25例,同时招募30例健康老年体检者作为对照。定量研究对象血清中miR-221相对表达量及催乳素(PRL)水平,通过受试者操作特征曲线分析诊断效能。结果miR-221相对表达量由高至低依次为NASH组、SNAFL组、对照组,组间比较P<0.001,PRL水平由高至低依次为对照组、SNAFL组、NASH组,P<0.05。miR-221与PRL水平对NAFLD诊断的AUC值分别为0.795及0.880,P<0.001。PRL对诊断NAFLD的灵敏度、特异度、阳性预测值、阴性预测值及约登指数分别为83.3%、87.7%、91.9%、75.8%、0.71,诊断效能优于miR-221。miR-221与PRL对SNAFL与NASH诊断的AUC值分别为0.862及0.710,P<0.001。miR-221对诊断SNAFL与NASH的灵敏度、特异度、阳性预测值、阴性预测值及约登指数分别为76.0%、85.0%、85.0%、76.0%、0.61,诊断效能优于PRL。结论血清miR-221及催乳素水平对于老年NAFLD均有较好诊断效能,且催乳素对NAFLD患者及正常人的区分效果优于miR-221,而miR-221对于区分SNAFL与NASH患者的效能优于催乳素。

Objective To investigate the value of serum miR-221 and prolactin levels in the early diagnosis of elderly non-alcoholic fatty liver disease.Methods We recruited 65 elderly patients diagnosed with nonalcoholic fatty liver disease(NAFLD)by liver biopsy from January 2019 to December 2019 in our hospital,including 40 patients in the simple non-alcoholic fatty liver(SNAFL)25 cases in the group and non-alcoholic steatohepatitis(NASH)group and recruited 30 healthy elderly who applied for physical examination as control.We quantified the relative expression level and PRL level of miR-221 in the serum of the research subjects,and analyze the diagnostic efficacy through the receiver operating characteristic curve.Results The relative expression levels of miR-221 were from high to low in NASH group,SNAFL group,and control group.The P value of each group was<0.001.From high to low,the PRL levels were in control group,SNAFL group,NASH group(all P<0.05).The AUC values of miR-221 and PRL for the diagnosis of NAFLD were 0.795 and 0.880,respectively,and the P values were both<0.001.The sensitivity,specificity,positive predictive value,negative predictive value,and Youden index of PRL for the diagnosis of NAFLD were 83.3%,87.7%,91.9%,75.8%,and 0.71,respectively,and the diagnostic efficacy was better than miR-221.The AUC values of miR-221 and PRL for the diagnosis of SNAFL and NASH were 0.862 and 0.710 respectively,and the P values were both<0.001.The sensitivity,specificity,positive predictive value,negative predictive value,and Yoden index of miR-221 for the diagnosis of SNAFL and NASH were 76.0%,85.0%,85.0%,76.0%,and 0.61,respectively,and the diagnostic efficacy was better than PRL.Conclusion Serum miR-221 and prolactin levels have good diagnostic efficacy for elderly patients with NAFLD,and prolactin is superior to miR-221 in distinguishing patients with NAFLD from normal people,and miR-221 is superior to prolactin in distinguishing SNAFL from NASH patients.