2型糖尿病合并非酒精性脂肪肝患者血清CMKLR1、 STAT3表达与肝纤维化的关系

The relationship between the expression of serum CMKLR1,STAT3 and liver fibrosis in patients with type 2 diabetes and non-alcoholic fatty liver disease

目的探究血清趋化因子样受体1(CMKLR1)、信号转导激活转录因子3(STAT3)表达与2型糖尿病合并非酒精性脂肪肝(NAFLD)患者肝纤维化的关系。方法选取2020年3月至2022年11月于该院接受治疗的94例2型糖尿病合并NAFLD患者为观察组,根据肝纤维化程度分为轻中度组52例和重度组42例。选取同期在该院收治的102例2型糖尿病患者为对照组。采用酶联免疫吸附试验法检测血清CMKLR1、STAT3水平,采用化学发光法测定肝纤维化指标Ⅲ型前胶原肽(PⅢP)、层黏连蛋白(LN)、Ⅳ型胶原(CⅣ)水平。采用Pearson相关性分析检验2型糖尿病合并NAFLD患者血清CMKLR1、STAT3水平与肝纤维化指标的相关性。绘制受试者工作特征曲线分析血清CMKLR1、STAT3水平对2型糖尿病合并NAFLD患者肝纤维化程度的预测效能。采用多因素Logistic回归分析检验影响2型糖尿病合并NAFLD患者肝纤维化程度的因素。结果观察组血清CMKLR1、STAT3水平高于对照组,差异有统计学意义(P<0.05)。重度组CMKLR1、STAT3及肝纤维化指标PⅢP、LN、CⅣ高于轻中度组,差异有统计学意义(P<0.05)。2型糖尿病合并NAFLD患者血清CMKLR1、STAT3水平与PⅢP、LN、CⅣ呈正相关(P<0.05)。血清CMKLR1、STAT3水平单独及联合预测2型糖尿病合并NAFLD患者肝纤维化发展为重度的曲线下面积分别为0.867、0.818、0.922。CMKLR1、STAT3是影响2型糖尿病合并NAFLD患者肝纤维化发展为重度的独立危险因素(P<0.05)。结论2型糖尿病合并NAFLD患者血清CMKLR1、STAT3升高可能与肝纤维化有关。

Objective To explore the relationship between the expression of serum chemokine-like receptor 1(CMKLR1),signal transducers and activators of transduction-3(STAT3) and liver fibrosis in patients with type 2 diabetes and non-alcoholic fatty liver disease(NAFLD).Methods Ninety-four patients with type 2 diabetes complicated with NAFLD who were treated in a hospital from March 2020 to November 2022 were regarded as the observation group,according to the degree of liver fibrosis,52 cases were grouped into mild to moderate group and 42 cases into severe group.A total of 102 patients with type 2 diabetes admitted to the hospital during the same period were selected as the control group.The levels of serum CMKLR1 and STAT3 were detected by enzyme-linked immunosorbent assay,the levels of type Ⅲ procollagen peptide(PⅢP),laminin(LN) and type Ⅳ collagen(CⅣ) were measured by chemiluminescence method.Pearson correlation analysis was applied to examine the correlation between serum CMKLR1,STAT3 levels and liver fibrosis indicators in patients with type 2 diabetes and NAFLD.The receiver operating characteristic curve was drawn to analyze the predictive efficacy of serum CMKLR1 and STAT3 levels on the degree of liver fibrosis in patients with type 2 diabetes and NAFLD.Multivariate Logistic regression analysis was applied to examine the factors affecting the degree of liver fibrosis in patients with type 2 diabetes and NAFLD.Results The levels of serum CMKLR1 and STAT3 in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).CMKLR1,STAT3 and PⅢP,LN and CⅣ of liver fibrosis in severe group were higher than those in mild and moderate groups,the difference was statistically significant(P<0.05).The levels of serum CMKLR1 and STAT3 in patients with type 2 diabetes and NAFLD were positively correlated with PⅢP,LN and CⅣ(P<0.05).The area under the curve of serum CMKLR1 and STAT3 levels alone and jointly predicting the severity of liver fibrosis in patients with type 2 diabetes and NAFLD was 0.867,0.818 and 0.922,respectively.CMKLR1 and STAT3 were independent risk factors that affect the degree of liver fibrosis in patients with type 2 diabetes and NAFLD to develop into severe(P<0.05).Conclusion The increase of serum CMKLR1 and STAT3 in patients with type 2 diabetes and NAFLD may be related to liver fibrosis.