非酒精性脂肪性肝病患者外周血内皮素、C型凝集素-1水平与小肠细菌过度生长、肝纤维化的关系

Relationship between levels of ET and Dectin-1 in peripheral blood of patients with non-alcoholic fatty liver disease and small intestinal bacterial overgrowth and liver fibrosis

目的探究非酒精性脂肪性肝病(NAFLD)患者外周血内皮素(ET)、C型凝集素-1(Dectin-1)水平与小肠细菌过度生长(SIBO)、肝纤维化的关系。方法选择2021年10月至2022年10月沧州市中心医院收治的88例NAFLD患者作为研究对象(设为NAFLD组),另选择同期在该院体检的65名健康体检者作为对照组。采用ELISA法检测受试者血清ET和Dectin-1水平。采用Pearson相关系数法分析NAFLD患者外周血ET、Dectin-1水平与SIBO的相关性。采用ROC曲线分析外周血ET、Dectin-1水平对NAFLD患者肝纤维化的评估价值。结果与对照组相比,NAFLD组的SIBO阳性率及血清ET、Dectin-1水平均显著升高,差异均有统计学意义(P均<0.001)。与SIBO阴性组相比,SIBO阳性组的乳果糖氢呼气试验(LHBT)集值及血清ET、Dectin-1水平均显著升高,差异均有统计学意义(P均<0.001)。Pearson相关性分析结果显示,NAFLD组血清ET、Dectin-1水平与LHBT集值均呈正相关(r=0.552,P<0.05;r=0.451,P<0.05)。与对照组相比,无肝纤维化组、轻度肝纤维化组和重度肝纤维化组的血清ET、Dectin-1水平均显著升高,且随肝纤维化程度加重,血清ET、Dectin-1水平随之升高(P均<0.05)。ROC曲线分析结果显示,血清ET、Dectin-1水平评估NAFLD患者肝纤维化的最佳截断值分别为65.63 pg/mL、18.52 pg/mL。血清ET和Dectin-1联合检测评估NAFLD患者肝纤维化的曲线下面积(AUC)均大于单项检测,差异均有统计学意义(P均<0.05),且联合检测的特异度较高。结论与健康人群相比,NAFLD患者外周血ET、Dectin-1水平均显著升高,且其水平与SIBO阳性率呈正相关。NAFLD患者外周血ET与Dectin-1联合检测评估患者肝纤维化具有一定应用价值。

Objective This paper is to investigate the relationship between the levels of endothelin(ET)and C-type lectin-1(Dectin-1)in peripheral blood of patients with non-alcoholic fatty liver disease(NAFLD)and small intestinal bacterial overgrowth(SIBO)and liver fibrosis.Methods A total of 88 patients with NAFLD admitted to Cangzhou Central Hospital between October 2021 and October 2022 were selected as the study subjects(the NAFLD group),and 65 healthy individuals who underwent physical examinations during the same period were selected as the control group.The ELISA method was used to detect serum ET and Dectin-1 levels.Pearson correlation analysis was used to explore the correlation between the levels of ET,Dectin-1,and SIBO in NAFLD patients.The ROC curve was used to analyze the value of ET and Dectin-1 levels in the assessment of liver fibrosis in NAFLD patients.Results Compared with the control group,the positive rate of SIBO and the levels of ET and Dectin-1 in the NAFLD group are significantly higher(P<0.001).Compared with the SIBO-negative group,the LHBT and the serum ET and Dectin-1 levels in the SIBO-positive group are significantly higher(P<0.001).Pearson correlation analysis shows that the levels of ET and Dectin-1 in the NAFLD group are positively correlated with LHBT(r=0.552 and P<0.05;r=0.451 and P<0.05).Compared with the control group,the serum levels of ET and Dectin-1 in the non-hepatic fibrosis group,mild hepatic fibrosis group,and severe hepatic fibrosis group significantly increase,and the serum levels of ET and Dectin-1 increase with the severity of hepatic fibrosis(P<0.05).The results of ROC curve analysis show that the best cut-off value of serum ET and Dectin-1 levels for evaluating hepatic fibrosis in NAFLD patients are 65.63 pg/mL and 18.52 pg/mL.The area under the curve(AUC)of serum ET combined with Dectin-1 in diagnosing hepatic fibrosis in NAFLD patients is significantly higher than that of single test(P<0.05),and the specificity of the combined test is higher.Conclusions Compared with the healthy people,the levels of ET and Dectin-1 in NAFLD patients significantly increase,which are positively correlated with the positive rate of SIBO.The combined detection of ET and Dectin-1 in the peripheral blood of the NAFLD patients may be useful in the assessment of liver fibrosis.