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