SREBP-1c及其相关模型诊断非酒精性脂肪性肝病的价值

    Value of SREBP-1c and its related model in the diagnosis of non-alcoholic fatty liver disease

    • 摘要: 目的: 以固醇调节元件结合蛋白-1c(SREBP-1c)为基础,联合血白细胞计数(WBC)、丙氨酸氨基转移酶(ALT)和三酰甘油(TG)建立非酒精性脂肪性肝病(NAFLD)无创诊断模型,明确SREBP-1c在诊断NAFLD中的效能及应用价值。方法: 选取175例NAFLD病人作为研究对象,同时选取健康人群144名作为健康对照组,应用双抗体夹心酶联免疫吸附法检测血清SREBP-1c表达水平,使用自动生化分析仪检测血清ALT和TG等指标水平,全自动血细胞分析仪检测外周血WBC等指标,利用ROC曲线分别评估以上4个指标及其构建的无创诊断模型诊断NAFLD的效能。结果: 与健康对照组相比,NAFLD组病人SREBP-1c、WBC、ALT、TG、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(γ-GGT)、空腹血糖(FPG)水平均明显升高(P < 0.05~P < 0.01)。二元logistic分析结果示SREBP-1c、WBC、ALT和TG等水平升高均为NAFLD患病的独立危险因素(OR=1.435、1.042、2.113、1.012,P < 0.05~P < 0.01)。以SREBP-1c为基础,联合WBC、ALT和TG建立的临床无创诊断模型ROC曲线下面积为0.918 2,灵敏度为84.03%,特异度为84.00%,诊断效能高于单一指标。结论: 以SREBP-1c为基础的临床无创诊断模型能够有效地提高NAFLD诊断的准确性,为临床诊疗提供参考依据。

       

      Abstract: Objective: To establish a non-invasive diagnostic model for non-alcoholic fatty liver disease(NAFLD) based on sterol regulatory element-binding protein-1c(SREBP-1c), combined with white blood cell count(WBC), alanine aminotransferase(ALT) and triglyceride (TG), and clarify the efficacy and application value of SREBP-1c in the diagnosis of NAFLD. Methods: A total of 175 patients with NAFLD were selected as the research subjects, and 144 healthy individuals were selected as the healthy control group.The expression level of serum SREBP-1c was detected by double antibody sandwich enzyme-linked immunosorbent assay.The levels of indicators such as serum ALT and TG were detected by automatic biochemical analyzer, and the peripheral blood WBC was detected by automatic blood cell analyzer.The ROC curve was used to evaluate the efficacy of the above four indicators and non-invasive diagnostic model constructed by them in diagnosing NAFLD. Results: Compared with the healthy control group, the levels of SREBP-1c, WBC, ALT, TG, aspartate aminotransferase(AST), γ-glutamyl transferase(γ-GGT), and fasting plasma glucose(FPG) in the NAFLD group significantly increased(P < 0.05 to P < 0.01).The results of binary logistic analysis showed that the increasing of SREBP-1c, WBC, ALT and TG levels were the independent risk factors of NAFLD(OR=1.435, 1.042, 2.113, 1.012, P < 0.05 to P < 0.01).The area under the ROC curve of the clinical non-invasive diagnostic model established based on SREBP-1c in combination with WBC, ALT and TG was 0.918 2, the sensitivity was 84.03%, the specificity was 84.00%, and the diagnostic efficacy was higher than that of a single indicator. Conclusions: The clinical non-invasive diagnostic model based on SREBP-1c can effectively improve the accuracy of NAFLD diagnosis and provide a reference basis for clinical diagnosis and treatment.

       

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