非酒精性脂肪性肝病患者血清LncRNA H19表达变化及临床意义

Change of serum LncRNA H19 expression in patients with non-alcoholic fatty liver disease and its clinical significance

目的:检测长链非编码RNA H19(lncRNA H19)在非酒精性脂肪性肝病(NAFLD)患者血清中表达情况,探讨LncRNA H19在NAFLD中的临床意义。方法:选择2019年1月—2020年12月收治的NAFLD患者137例作为研究对象,根据CT影像学表现将NAFLD患者分为轻度脂肪肝组(57例),中度脂肪肝组(46例)和重度脂肪肝组(34例),另选取同期体检的患者(无脂肪变性和脂肪性肝炎的其他肝病)140例作为对照组。qRT-PCR检测血清LncRNA H19的表达情况,Pearson法分析血清LncRNA H19与各生化指标相关性,ROC曲线分析血清LncRNA H19对NAFLD的诊断价值。结果:与对照组比较,NAFLD患者血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)等显著升高(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平显著降低(P<0.05);与对照组比较,NAFLD患者血清LncRNA H19表达水平显著升高(P<0.05);不同程度NAFLD患者之间血清LncRNA H19表达水平差异有统计学意义(P<0.05),与轻度组比较,中度组与重度组患者血清LncRNA H19表达水平显著升高(P<0.05),与中度组比较,重度组患者血清LncRNA H19表达水平显著升高(P<0.05);相关性分析显示,NAFLD患者血清LncRNA H19与TG、LDL-C、HOMA-IR呈正相关(P<0.05),与HDL-C、ALT、AST、ALP、GGT、TC相关性不明显(P>0.05);血清LncRNA H19预测NAFLD的曲线下面积为0.831,截断值为1.20,敏感度为84.67%,特异度为83.57%。结论:LncRNA H19在NAFLD患者血清中高表达,与肝脏脂肪变性及严重程度有关,可能是预测NAFLD的潜在标志物。

Objective:To detect the expression of long-chain non-coding RNA H19(LncRNA H19)in the serum of patients with non-alcoholic fatty liver disease(NAFLD),and to explore the clinical significance of LncRNA H19 in NAFLD.Methods:One hundred and thirty-seven NAFLD patients who were admitted to our hospital from January 2019 to December 2020 were selected as the research objects.According to CT imaging findings,the NAFLD patients were divided into fifty-seven cases of mild fatty liver group,forty-six cases of moderate fatty liver group and thirty-four cases of the severe fatty liver group,in addition,one hundred and forty patients(other liver diseases without steatosis and steatohepatitis)who underwent physical examination in our hospital during the same period were selected as the control group.QRT-PCR was used to detect the expression of serum LncRNA H19,Pearson method was used to analyze the correlation between serum LncRNA H19 and various biochemical indicators,ROC curve was used to analyze the diagnostic value of serum LncRNA H19 for NAFLD.Results:Compared with the control group,the serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyltransferase(GGT),alkaline phosphatase(ALP),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),insulin resistance index(HOMA-IR)in NAFLD patients were significantly higher(P<0.05),and the level of high-density lipoprotein cholesterol(HDL-C)was significantly lower(P<0.05);compared with the control group,the expression level of serum LncRNA H19 in NAFLD patients was significantly higher(P<0.05);the expression level of serum LncRNA H19 in patients with different degrees of NAFLD was different(P<0.05),compared with mild group,the expression level of serum LncRNA H19 in moderate group and severe group was significantly higher(P<0.05),and compared with moderate group,the expression level of serum LncRNA H19 in severe group was significantly higher(P<0.05);correlation analysis showed that serum LncRNA H19 was positively correlated with TG,LDL-C and HOMA-IR(P<0.05),but not with HDL-C,ALT,AST,ALP,GGT and TC(P>0.05);the area under the curve of serum LncRNA H19 for predicting NAFLD was 0.831,the cutoff value was 1.20,the sensitivity was 84.67%,and the specificity was 83.57%.Conclusion:LncRNA H19 is highly expressed in the serum of NAFLD patients,which is related to hepatic steatosis and severity,and may be a potential marker for predicting NAFLD.