非酒精性脂肪性肝病患者外周血单个核细胞中沉默信息调节因子7的水平及其意义

Level and Significance of SIRT7 in Peripheral Blood Mononuclear Cells of Patients with Non-alcoholic Fatty Liver Disease

【目的】探讨非酒精性脂肪性肝病(NAFLD)患者外周血单个核细胞中沉默信息调节因子7(SIRT7)的水平及其意义。【方法】三个医院就诊的205例NAFLD患者为NAFLD组,同期参加健康体检的100例受试者作为对照组。采用Ficoll密度梯度离心法分离外周血中单个核细胞;采用蛋白质免疫印迹法检测单个核细胞中SIRT7表达水平。分析SIRT7水平与NAFLD严重程度的关系。【结果】NAFLD组SIRT7表达水平低于对照组,且差异有统计学意义(P<0.05)。随着NAFLD病情加重,SIRT7表达水平逐渐降低。SIRT7诊断中重度NAFLD的受试者工作特征(ROC)曲线下面积、敏感度和特异度分别为0.890、75.61%和87.80%。Logistic回归分析结果显示:空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和SIRT7均是进展为中重度NAFLD的独立危险因素(P<0.05)。由FPG、TC、TG、ALT、AST和SIRT7构建的预测中重度NAFLD的列线图模型的拟合曲线与理想曲线重合度极高,C-index为0.963。【结论】NAFLD患者外周血单个核细胞中SIRT7表达水平低提示其病情严重。由FPG、TC、TG、ALT、AST和SIRT7构建的列线图模型具有较高的区分度和精准度,可有效判断中重度NAFLD。

【Objective】To investigate the level and significance of silent information regulator 7(SIRT7)in peripheral blood mononuclear cells of patients with non-alcoholic fatty liver disease(NAFLD).【Methods】A total of 205 patients with NAFLD(the NAFLD group)were selected as the research subjects from three hospitals.Healthy volunteers who participated in the health examination at the same time were selected as the control group(n=100).Ficoll density gradient centrifugation was used to isolate mononuclear cells in peripheral blood;Western blot was used to detect the expression level of SIRT7 in mononuclear cells.The relationship between SIRT7 and the severity of NAFLD was analyzed.【Results】The expression level of SIRT7 in the NAFLD group was lower than that in control group,the difference was statistically significant(P<0.05).With the aggravation of NAFLD,the expression level of SIRT7 gradually decreased.The area under ROC curve,sensitivity and specificity of SIRT7 in the diagnosis of moderate and severe NAFLD were 0.890,75.61%and 87.80%,respectively.Logistic regression analysis showed that FPG,TC,TG,ALT,AST,and SIRT7 were all independent risk factors for progression to moderate and severe NAFLD(P<0.05).The predicted curve constructed by FPG,TC,TG,ALT,AST,and SIRT7 had a high degree of coincidence between the fit curve of the nomogram model and the ideal curve with a C-index of 0.963.【Conclusion】The low expression level of SIRT7 in peripheral blood mononuclear cells of NAFLD patients indicates that the disease is serious.The nomogram models constructed by FPG,TC,TG,ALT,AST,and SIRT7 have high discrimination and precision,and can effectively judge moderate and severe NAFLD.