血清FNDC5和CTRP12表达水平与代谢相关脂肪性肝病的临床相关性

Clinical correlation between serum FNDC5 and CTRP12 expression levels and metabolismrelated fatty liver disease

目的 探究血清Ⅲ型纤连蛋白结构域5(FNDC5)和补体C1q/肿瘤坏死因子相关蛋白12(CTRP12)表达水平与代谢相关脂肪性肝病(MAFLD)患者糖脂代谢、肝功能的相关性。方法 选择2019年6月至2022年6月在洪湖市妇幼保健院和襄阳市中心医院就诊的100例MAFLD患者作为研究对象(设为MAFLD组),另选择同期洪湖市妇幼保健院体检中心的100名健康体检者作为对照组。采用ELISA法检测血清FNDC5和CTRP12表达水平。采用Pearson相关性分析探讨血清FNDC5、CTRP12与MAFLD患者糖脂代谢、肝功能的关系。采用ROC曲线分析血清FNDC5和CTRP12表达水平对MAFLD的诊断价值。采用logistic回归模型分析影响MAFLD发生的危险因素。结果 与对照组相比,MAFLD组的ALT、AST、白蛋白(ALB)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TC)、总胆固醇(TG)、空腹血糖(FBG)、空腹胰岛素(FINS)水平和胰岛素抵抗指数(HOMA-IR)均显著升高,差异均有统计学意义(P均<0.05)。与对照组相比,MAFLD组的血清FNDC5表达水平显著升高,血清CTRP12表达水平显著降低,差异均有统计学意义(P均<0.05)。Pearson相关性分析结果显示,MAFLD组的血清FNDC5表达水平与ALT、FBG、TG、FINS和HOMA-IR均呈显著正相关(r=0.504、0.496、0.474、0.418、0.501,P均<0.001);血清CTRP12表达水平与ALT、FBG、TG、FINS和HOMA-IR均呈显著负相关(r=-0.496、-0.421、-0.403、-0.425、-0.496,P均<0.001)。ROC曲线分析结果显示,血清FNDC5和CTRP12联合检测诊断MAFLD的曲线下面积(AUC)为0.860,分别大于单项检测;此外,联合检测的敏感度、特异度分别均分别高于单项检测。多因素logistic回归模型分析结果显示,TG、HOMA-IR和FNDC5均是MAFLD发生的独立危险因素,而CTRP12是MAFLD发生的保护因素(P均<0.05)。结论 MAFLD患者的血清FNDC5表达上调,血清CTRP12表达下调,且均与糖脂代谢、肝功能密切相关,其可能可以成为诊断MAFLD的生物标志物。

Objective This paper is to investigate the correlation between serum fibronectin typeⅢdomain 5(FNDC5)and complement C1q/tumor necrosis factor-related protein 12(CTRP12)expression levels with glucose and lipid metabolism and liver function in patients with metabolic-related fatty liver disease(MAFLD).Methods A total of 100 patients with MAFLD admitted to Honghu Maternal and Child Health Hospital and Xiangyang Central Hospital from June 2019 to June 2022 were selected and assigned to the MAFLD group,and 100 healthy individuals who were examined in the medical examination center of Honghu Maternal and Child Health Hospital during the same period were selected and assigned to the control group.The serum FNDC5 and CTRP12 levels were detected by ELISA.The correlation between serum FNDC5,CTRP12,glucose and lipid metabolism,and liver function in MAFLD patients was analyzed by Pearson correlation analysis.The ROC curve was performed to analyze the diagnostic value of serum FNDC5 and CTRP12 for MAFLD.The logistic regression analysis was conducted to explore the risk factors affecting the occurrence of MAFLD.Results The levels of ALT,AST,ALB,HDL-C,LDL-C,TC,TG,FBG,FINS,and HOMA-IR in the MAFLD group are higher than those in the control group,with statistically significant differences(P<0.05).Compared with the control group,the MAFLD group has an increase in serum FNDC5 levels and a decrease in serum CTRP12 levels,with statistically significant differences(P<0.05).The Pearson correlation analysis results show that the serum FNDC5 levels in patients are positively correlated with ALT,FBG,TG,FINS,and HOMA-IR(r=0.504,0.496,0.474,0.418,0.501,and P<0.05),while the serum CTRP12 levels in patients are negatively correlated with ALT,FBG,TG,FINS,and HOMA-IR(r=-0.496,-0.421,-0.403,-0.425,-0.496,and P<0.05).The results of ROC curve analysis show that the area under the curve(AUC)of serum FNDC5 combined with CTRP12 in the diagnosis of MAFLD is 0.860,which is greater than that of single detection.In addition,the sensitivity and specificity of combined detection are higher than those of single detection.The results of the multiple logistic regression model analysis show that TG,HOMA-IR,and FNDC5 are risk factors for MAFLD,and serum CTRP12 is a protective factor(P<0.05).Conclusion The upregulation of serum FNDC5 and downregulation of serum CTRP12 in patients with MAFLD are closely related to the indexes of glucose and lipid metabolism and liver function,and may be a biomarker for the diagnosis of MAFLD.