血管生成素样蛋白4在非酒精性脂肪肝诊断中的应用效果分析

doi:10.3969/j.issn.1006-7795.2020.01.006

首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (1): 31-34.doi: 10.3969/j.issn.1006-7795.2020.01.006

• 糖尿病的临床与基础研究 • 上一篇下一篇

血管生成素样蛋白4在非酒精性脂肪肝诊断中的应用效果分析

杨龙艳, 王岩, 许月超, 程雅楠, 马燕, 赵冬

首都医科大学附属北京潞河医院内分泌代谢与免疫性疾病中心糖尿病防治研究北京市重点实验室, 北京 101149

收稿日期:2019-12-12 出版日期:2020-02-21 发布日期:2020-02-13
通讯作者: 赵冬 E-mail:zhaodong@ccmu.edu.cn
基金资助:
国家自然科学基金（81800768），北京市自然科学基金（7184222）。

Effect of angiopoietin-like 4 in the diagnosis of nonalcoholic fatty liver

Yang Longyan, Wang Yan, Xu Yuechao, Cheng Yanan, Ma Yan, Zhao Dong

Beijing Key Laboratory of Diabetes Prevention and Research, Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China

Received:2019-12-12 Online:2020-02-21 Published:2020-02-13
Supported by:
This study was supported by National Science Funding of China (81800768), Natural Science Foundation of Beijing (7184222).

摘要/Abstract

摘要： 目的研究血清中血管生成素样蛋白4（angiopoietin-like 4，ANGPTL4）与非酒精性脂肪肝（non-alcoholic fatty liver disease，NAFLD）及严重程度的关系，探讨ANGPTL4用于诊断NAFLD的价值。方法选择首都医科大学附属北京潞河医院2018年1月至12月诊断为NAFLD的患者52例为病例组，同期选择47例健康者为对照组。所有研究对象都由同一名超声科医生进行了腹部超声检查，并将NAFLD患者分为轻度、中度和重度。排除糖尿病、冠状动脉粥样硬化性心脏病（以下简称冠心病）、脑血管病、慢性肝病、服用降脂药或其他药物的患者。用酶联免疫吸附法（enzyme linked immunosorbent assay，ELISA）定量检测血清ANGPTL4的浓度，分析对照组与轻、中、重度NAFLD患者ANGPLT4的差异。以超声诊断为金标准，分析ANGPTL4作为NAFLD潜在的血清分子标志物的可能性。结果与对照组相比，NAFLD患者血清ANGPTL4浓度升高，并随着NAFLD的严重程度有升高趋势（F=4.553，P=0.035 4）。ANGPTL4的受试者工作特征曲线（receiver operating characteristic curve，ROC）下面积为0.638，以最大约登指数确定NAFLD的诊断阈值，最佳临界值为90.93 ng/mL。以此标准诊断的结果与超声诊断结果进行比较，灵敏度=100%，特异度=46.8%，Kappa=0.48。结论血清ANGPTL4浓度与NAFLD及其严重程度有关，用于NAFLD临床辅助诊断的误诊率较高。

关键词: 血管生成素样蛋白4, 非酒精性脂肪肝, 血清分子标志物

Abstract: Objective To study the relationship between angiopoietin like protein 4 (ANGPTL4) and non-alcoholic fatty liver disease (NAFLD), and to explore the value of ANGPTL4 in the diagnosis of NAFLD. Methods Totally 52 patients with NAFLD and 47 normal controls were selected from Beijing Luhe Hospital, Capital Medical University from January to December 2018. All subjects were examined by the same ultrasound doctor. The patients were diagnosed with mild and moderate to severe NAFLD. Patients with diabetes, coronary heart disease, cerebrovascular disease, chronic liver disease, taking lipid-lowering drugs or other drugs are excluded. The level of serum ANGPTL4 was measured with enzyme linked immunosorbent assay (ELISA). The difference of ANGPTL4 between the control and NAFLD groups, as well as the patients with mild, moderate and severe NAFLD was analyzed. The relationship between ANGPTL4 and NAFLD was analyzed with clinical case-control study. The possibility of ANGPTL4 as a potential serum molecular marker for NAFLD was analyzed with ultrasonic diagnosis as the gold standard. Results Compared with the control group, the level of serum ANGPTL4 in patients with NAFLD increased and tended to increase with the severity of NAFLD (F=4.553, P=0.035 4). The area under the (receiver operating characteristic curve, ROC) curve of ANGPTL4 was 0.638, and the diagnostic threshold of NAFLD was determined with the maximum Jordan index. The optimal threshold was 90.93 ng/mL. The results of this standard were compared with those of ultrasonic diagnosis. Sensitivity=100%, specificity=46.8%, kappa=0.48. Conclusion The serum ANGPTL4 level was related to NAFLD and its severity, but the misdiagnosis rate of clinical assistant diagnosis of NAFLD was high.

Key words: angiopoietin-like 4, nonalcoholic fatty liver, serum molecular marker

中图分类号:

杨龙艳, 王岩, 许月超, 程雅楠, 马燕, 赵冬. 血管生成素样蛋白4在非酒精性脂肪肝诊断中的应用效果分析[J]. 首都医科大学学报, 2020, 41(1): 31-34.

Yang Longyan, Wang Yan, Xu Yuechao, Cheng Yanan, Ma Yan, Zhao Dong. Effect of angiopoietin-like 4 in the diagnosis of nonalcoholic fatty liver[J]. Journal of Capital Medical University, 2020, 41(1): 31-34.

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血管生成素样蛋白4在非酒精性脂肪肝诊断中的应用效果分析

Effect of angiopoietin-like 4 in the diagnosis of nonalcoholic fatty liver

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