非酒精性脂肪性肝病患者血清微小RNA-143、Toll样受体2水平变化及其临床意义

Changes and clinical significance of serum miR-143 and TLR2 in patients with nonalcoholic fatty liver disease

目的:检测微小RNA-143(miR-143)、Toll样受体2(TLR2)在非酒精性脂肪性肝病(NAFLD)患者血清中表达情况,探讨miR-143、TLR2与NAFLD患者肝纤维化的相关性。方法:选择2019年1月至2020年7月在本院治疗的NAFLD患者121例,根据NFS评分将患者分为非进展性肝纤维化组(NFS≤0.676分,简称非进展组)68例和进展性肝纤维化组(NFS>0.676分,简称进展组)53例。选择同期健康体检人员100例作为对照组。实时荧光定量PCR(qRT-PCR)法检测血清miR-143水平;酶联免疫吸附法检测血清TLR2水平。同时检测其他血清因子水平,Pearson法分析肝纤维化NFS评分与患者miR-143、TLR2及相关指标的相关性。结果:进展组和非进展组患者体重指数(BMI)及血清丙氨酸氨基转移酶(ALT),天门冬氨酸氨基转移酶(AST)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、TLR2水平较对照组人员显著升高,而miR-143、高密度脂蛋白胆固醇(HDL-C)水平显著降低,差异均有统计学意义(均P<0.05);与非进展组比较,进展组患者血清TLR2水平升高,miR-143表达水平显著降低,差异有统计学意义(P<0.05);相关性分析显示肝纤维化患者NFS评分与TLR2、ALT、AST、TC、TG、LDL-C、HbA1c呈正相关,与miR-143、HDL-C呈负相关(均P<0.05)。结论:在NAFLD患者血清中miR-143呈低表达,TLR2呈高表达,两者水平与肝纤维化有关,可作为预测NAFLD患者肝纤维化潜在的标志物。

Objective:To detect the expression of microRNA-143(miR-143)and toll like receptor 2(TLR2)in serum of patients with nonalcoholic fatty liver disease(NAFLD),and to explore the correlation between miR-143,TLR2 and liver fibrosis in patients with NAFLD.Methods:A total of 121 patients with NAFLD treated in our hospital from January 2019 to July 2020 was selected and divided into 68 cases of nonprogressive liver fibrosis group(NFS≤0.676 points)and 53 cases of progressive liver fibrosis group(NFS>0.676 points),100 cases of healthy physical examination personnel during the same period were selected as the control group.The level of serum miR-143 was detected by real-time fluorescent quantitative PCR(qRT-PCR),the level of serum TLR2 was measured by enzyme linked immunosorbent assay,at the same time,the levels of other serum factors were detected and the correlation between liver fibrosis NFS score and miR-143,TLR2 and related indicators was analyzed by Pearson method.Results:The body index(BMI)and serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),glycosylated hemoglobin(HbA1c),TLR2 levels increased significantly,the levels of miR-143 and high density lipoprotein cholesterol(HDL-C)were significantly decreased(P<0.05);compared with those in the non progressive liver fibrosis group,the level of serum TLR2 was higher and the expression level of miR-143 was significantly lower in the progressive liver fibrosis group(P<0.05);the correlation analysis showed that the score of NFS was positively correlated with TLR2,alt,AST,TC,TG,LDL-C and HbA1c,and negatively correlated with miR-143 and HDL-C(P<0.05).Conclusion:The expression of miR-143 is low and TLR2 is high in NAFLD patients.The levels of miR-143 and TLR2 are related to liver fibrosis,which may be used as potential markers to predict liver fibrosis in NAFLD patients.