与 2 型糖尿病患者肝纤维化相关的血清生物标志物

IF 0.7 Q4 ENDOCRINOLOGY & METABOLISM
Diabetes Mellitus Pub Date : 2024-03-18 DOI:10.14341/dm13059
Y. A. Krasner, V. Romanov, O. N. Fazullina, M. F. Osipenko, V. Klimontov
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引用次数: 0

摘要

背景:肝纤维化的诊断是治疗非酒精性脂肪肝(NAFLD)和 2 型糖尿病患者的一项重要任务。目前使用的诊断方法有许多缺点,如侵入性强、成本高或灵敏度和特异性不足。因此,寻找新的肝纤维化非侵入性标记物仍是一项实际挑战。目的:评估血清生长分化因子-15(GDF-15)、微纤维相关糖蛋白4(MFAP-4)、胶原蛋白IV型α1(COL4alpha1)、Mac-2结合蛋白(M2BPGI)和几丁质酶-3样蛋白1(YKL-40)作为2型糖尿病和非酒精性脂肪肝患者肝纤维化标志物的诊断价值。研究包括 74 名患者,其中男性 23 人,女性 51 人,年龄在 18 至 74 岁之间。肝脏弹性成像是评估肝纤维化的参考方法。评估了 APRI 和 fib-4(非侵入性纤维化指数)。血清中 GDF-15、MFAP-4、COL4alpha1、M2BPGI 和 YKL-40 的浓度是通过 ELISA 法测定的。结果:16 名受试者的肝纤维化分期为 1 期,12 名受试者的肝纤维化分期为 2 期,7 名受试者的肝纤维化分期为 3 期,19 名受试者的肝纤维化分期为 4 期。与无严重肝纤维化(0-2期)的患者相比,肝纤维化晚期(3-4期)患者的GDF-15(p=0.003)、COL4alpha1(p=0.007)和YKL-40(p=0.04)水平较高。与没有任何肝纤维化迹象的患者相比,1-2 期肝纤维化患者的 COL4alpha 水平更高(p=0.02)。不同严重程度的肝纤维化患者的 MFAP-4 和 M2BPGI 水平无明显差异。根据ROC分析,GDF-15、COL4alpha1和YKL-40在检测严重肝纤维化方面的诊断价值与APRI和fib-4指数相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum biomarkers associated with liver fibrosis in patients with type 2 diabetes
BACKGROUND: The diagnosis of liver fibrosis is an important task in the management of patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes. The currently used diagnostic methods have a number of disadvantages such as invasiveness and high cost, or insufficient sensitivity and specificity. Therefore, the search for new non-invasive markers of liver fibrosis remains an actual challenge.AIM: To assess a diagnostic value of serum growth differentiation factor-15 (GDF-15), microfibril-associated glycoprotein 4 (MFAP-4), collagen type IV alpha1 (COL4alpha1), Mac-2 binding protein (M2BPGI) and chitinase-3-like protein 1 (YKL-40) as markers of liver fibrosis in patients with type 2 diabetes and NAFLD.MATERIALS AND METHODS: A single center cross-sectional observational study was performed. The study included 74 patients, 23 men and 51 women, aged 18 to 74 years. Liver elastography was used as reference method for the fibrosis evaluation. APRI and fib-4, non-invasive fibrosis indices, were assessed. Serum concentrations of GDF-15, MFAP-4, COL4alpha1, M2BPGI, and YKL-40 were determined by ELISA. ROC analysis was used to evaluate the sensitivity and specificity of serum markers for the diagnosis of the liver fibrosis.RESULTS: Liver fibrosis stage 1 was verified in 16 subjects, stage 2 in 12, stage 3 in 7, and stage 4 in 19. Patients with advanced liver fibrosis (stages 3–4), compared with those without severe fibrosis (stages 0–2), had higher levels of GDF-15 (p=0.003), COL4alpha1 (p=0.007), and YKL-40 (p=0.04). Patients with stage 1-2 liver fibrosis had higher levels of COL4alpha compared to those without any signs of fibrosis (p=0.02). There were no significant differences in the level of MFAP-4 and M2BPGI between patients with different severity of fibrosis. According to the ROC analysis, GDF-15, COL4alpha1 and YKL-40 have diagnostic value in the detection of severe liver fibrosis comparable to that of the APRI and fib-4 indices.CONCLUSION: GDF-15, COL4alpha1 and YKL-40 could be considered as promising non-invasive markers of liver fibrosis in patients with type 2 diabetes and NAFLD.
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来源期刊
Diabetes Mellitus
Diabetes Mellitus ENDOCRINOLOGY & METABOLISM-
CiteScore
1.90
自引率
40.00%
发文量
61
审稿时长
7 weeks
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