BACKGROUND Fibroblast growth factor 19(FGF-19)is one of the founding members of the endocrine FGF subfamily.Recently,it has been the subject of much interest owing to its role in various physiological processes affect...BACKGROUND Fibroblast growth factor 19(FGF-19)is one of the founding members of the endocrine FGF subfamily.Recently,it has been the subject of much interest owing to its role in various physiological processes affecting glucose and lipid metabolism and the regulation of bile acid secretion as well as cell proliferation,differentiation,and motility.Additionally,FGF-19 secretion in an autocrine style has reportedly contributed to cancer progression in various types of malignancies including hepatocellular carcinoma(HCC).AIM To estimate the serum FGF-19 concentrations in HCC cases and assess its diagnostic performance for the detection of HCC.METHODS We recruited 90 adult participants and divided them into three equal groups:Healthy controls,cirrhosis patients,and HCC patients.Serum FGF-19 concentrations were measured using the Human FGF-19 ELISA kit.RESULTS We detected a high statistically significant difference in serum FGF-19 levels among the three groups.The highest level was observed in the HCC group,followed by the cirrhosis and control groups(236.44±40.94 vs 125.63±31.54 vs 69.60±20.90 pg/mL,respectively,P≤0.001).FGF-19 was positively correlated with alpha fetoprotein(AFP;r=0.383,P=0.003)and international normalised ratio(r=0.357,P=0.005),while it was negatively correlated with albumin(r=-0.500,P≤0.001).For the detection of HCC,receiver operating characteristic curve analysis showed that the best cut-off point of AFP was>8.2 ng/mL with an area under the curve(AUC)of 0.78,sensitivity of 63.33%,specificity of 83.33%,positive predictive value(PPV)of 79.2%,negative predictive value(NPV)of 69.4%,and total accuracy of 78%.However,FGF-19 at a cut-off point>180 pg/mL had an AUC of 0.98,sensitivity of 100%,specificity of 90.0%,PPV of 90.0%,NPV of 100%,and total accuracy of 98%.CONCLUSION FGF-19 represents a possible novel non-invasive marker for HCC.It may improve the prognosis of HCC patients due to its utility in several aspects of HCC detection and management.展开更多
目的评价艾塞那肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者的疗效,并探讨其作用机制及临床安全性。方法选取张家港市中医院2014年1月-2015年11月收治的T2DM伴发NAFLD患者96例,使用数字法随机分为对照组和治疗组,每组48人。...目的评价艾塞那肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者的疗效,并探讨其作用机制及临床安全性。方法选取张家港市中医院2014年1月-2015年11月收治的T2DM伴发NAFLD患者96例,使用数字法随机分为对照组和治疗组,每组48人。对照组患者口服二甲双胍,起始剂量500 mg/次,2次/d,结合具体病情调整药物剂量;治疗组在对照组基础上加用艾塞那肽注射液,早餐前60 min、晚餐前60 min 5μg皮下注射,均连续用药24周。比较治疗前后两组空腹血糖(FBG)、餐后血糖(PPG)、三酰甘油(TG)、总胆固醇(TC)、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)的变化,临床有效率及不良反应情况;ELISA法检测成纤维细胞生长因子19(FGF19)和FGF21表达的变化。结果两组治疗后FBG、PPG、TG、TC、ALT、AST、BMI、腰围、B超肝内贮脂量均显著减低(P<0.05、0.01),且治疗组均显著低于对照组(P<0.05)。两组治疗后FGF19和FGF21表达均显著升高(P<0.05、0.01),且治疗组FGF19和FGF21表达显著高于对照组(P<0.05)。治疗组的临床治疗有效率为85.4%,显著优于对照组的64.6%(P<0.05);治疗组不良反应率为12.5%,对照组的为10.4%,两组比较无显著性差异(P>0.05)。结论艾塞那肽联合二甲双胍对T2DM伴发NAFLD患者的血糖、血脂以及肝功能具有显著的改善作用,临床使用有效且安全。展开更多
文摘BACKGROUND Fibroblast growth factor 19(FGF-19)is one of the founding members of the endocrine FGF subfamily.Recently,it has been the subject of much interest owing to its role in various physiological processes affecting glucose and lipid metabolism and the regulation of bile acid secretion as well as cell proliferation,differentiation,and motility.Additionally,FGF-19 secretion in an autocrine style has reportedly contributed to cancer progression in various types of malignancies including hepatocellular carcinoma(HCC).AIM To estimate the serum FGF-19 concentrations in HCC cases and assess its diagnostic performance for the detection of HCC.METHODS We recruited 90 adult participants and divided them into three equal groups:Healthy controls,cirrhosis patients,and HCC patients.Serum FGF-19 concentrations were measured using the Human FGF-19 ELISA kit.RESULTS We detected a high statistically significant difference in serum FGF-19 levels among the three groups.The highest level was observed in the HCC group,followed by the cirrhosis and control groups(236.44±40.94 vs 125.63±31.54 vs 69.60±20.90 pg/mL,respectively,P≤0.001).FGF-19 was positively correlated with alpha fetoprotein(AFP;r=0.383,P=0.003)and international normalised ratio(r=0.357,P=0.005),while it was negatively correlated with albumin(r=-0.500,P≤0.001).For the detection of HCC,receiver operating characteristic curve analysis showed that the best cut-off point of AFP was>8.2 ng/mL with an area under the curve(AUC)of 0.78,sensitivity of 63.33%,specificity of 83.33%,positive predictive value(PPV)of 79.2%,negative predictive value(NPV)of 69.4%,and total accuracy of 78%.However,FGF-19 at a cut-off point>180 pg/mL had an AUC of 0.98,sensitivity of 100%,specificity of 90.0%,PPV of 90.0%,NPV of 100%,and total accuracy of 98%.CONCLUSION FGF-19 represents a possible novel non-invasive marker for HCC.It may improve the prognosis of HCC patients due to its utility in several aspects of HCC detection and management.
文摘目的评价艾塞那肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者的疗效,并探讨其作用机制及临床安全性。方法选取张家港市中医院2014年1月-2015年11月收治的T2DM伴发NAFLD患者96例,使用数字法随机分为对照组和治疗组,每组48人。对照组患者口服二甲双胍,起始剂量500 mg/次,2次/d,结合具体病情调整药物剂量;治疗组在对照组基础上加用艾塞那肽注射液,早餐前60 min、晚餐前60 min 5μg皮下注射,均连续用药24周。比较治疗前后两组空腹血糖(FBG)、餐后血糖(PPG)、三酰甘油(TG)、总胆固醇(TC)、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)的变化,临床有效率及不良反应情况;ELISA法检测成纤维细胞生长因子19(FGF19)和FGF21表达的变化。结果两组治疗后FBG、PPG、TG、TC、ALT、AST、BMI、腰围、B超肝内贮脂量均显著减低(P<0.05、0.01),且治疗组均显著低于对照组(P<0.05)。两组治疗后FGF19和FGF21表达均显著升高(P<0.05、0.01),且治疗组FGF19和FGF21表达显著高于对照组(P<0.05)。治疗组的临床治疗有效率为85.4%,显著优于对照组的64.6%(P<0.05);治疗组不良反应率为12.5%,对照组的为10.4%,两组比较无显著性差异(P>0.05)。结论艾塞那肽联合二甲双胍对T2DM伴发NAFLD患者的血糖、血脂以及肝功能具有显著的改善作用,临床使用有效且安全。
