血清胆汁酸谱在非酒精性脂肪性肝病患者中的表达及意义

肝脏 ›› 2021, Vol. 26 ›› Issue (11): 1279-1282.

血清胆汁酸谱在非酒精性脂肪性肝病患者中的表达及意义

朱悦, 钱晓寒, 季国忠, 杨丽华

210011 江苏南京市第二医院(朱悦);南京医科大学第二附属医院(钱晓寒,季国忠,杨丽华)

收稿日期:2020-12-25 出版日期:2021-11-30 发布日期:2021-12-24
通讯作者: 杨丽华,Email:hualiyang6501@126.com;季国忠,Email:jgz@njmu.edu.cn

The expression of serum bile acid profile in patients with nonalcoholic fatty liver disease

ZHU Yue¹, QIAN Xiao-han², JI Guo-zhong², YANG Li-hua²

1. the Second Hospital of Nanjing, Jiangsu 210037, China;
2. the Second Hospital affilited to Second Affiliated Hospital of Nanjing Medical University, Jiangsu 210011, China

Received:2020-12-25 Online:2021-11-30 Published:2021-12-24
Contact: YANG Li-hua, Email:hualiyang6501@126.com;JI Guo-zhong, Email:jgz@njmu.edu.cn

摘要/Abstract

摘要： 目的探索胆汁酸谱系在NAFLD中的变化及应用价值。方法选取2019年7月至2020年7月至南京医科大学第二附属医院就诊的60名NAFLD患者及54名健康体检者为研究对象,收集受试者的临床资料及血液标本,采用高效液相色谱-串联质谱法(LC-MS/MS)检测受试者血清中15种胆汁酸的水平并进行相关统计分析。结果与健康对照组相比,NAFLD组胆酸(CA)、鹅脱氧胆酸(CDCA)、甘氨胆酸(GCA)含量明显升高、石胆酸(LCA)含量明显降低(P<0.05),其余11种胆汁酸包括脱氧胆酸(DCA)、熊脱氧胆酸(UDCA)、甘氨石胆酸(GLCA)、甘氨脱氧胆酸(GDCA)、甘氨鹅脱氧胆酸(GCDCA)、甘氨熊脱氧胆酸(GUDCA)、牛磺胆酸(TCA)、牛磺石胆酸(TLCA)、牛磺脱氧胆酸(TDCA)、牛磺鹅脱氧胆酸(TCDCA)、牛磺熊脱氧胆酸(TUDCA)含量均无统计学差异(P>0.05);在NAFLD组中,血清DCA、GCA、GDCA、GCDCA、TCA、TCDCA水平与ALT、AST均呈正相关;BMI、LCA水平与NAFLD发病风险相关[OR(95%CI)分别为1.615(1.224,2.131)、0.946(0.906,0.987),P值均<0.05];胆汁酸谱中诊断评估能力较高的有CA(AUC=0.640)、CDCA(AUC=0.617)、GCA(AUC=0.634)。结论非酒精性脂肪性肝病患者血清胆汁酸谱发生明显改变,做好胆汁酸谱的分析对NAFLD患者病情的诊断评估具有积极意义。

关键词: 非酒精性脂肪性肝病, 胆汁酸谱, 无创诊断

Abstract: Objective To explore the changes and application value of serum bile acid profile in patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 60 patients with NAFLD and 54 healthy individuals from Second Affiliated Hospital of Nanjing Medical University were enrolled between July 2019 and July 2020. Clinical data and blood samples were collected and high-performance liquid chromatography-mass spectrometry (LC-MS/MS) was used to determine 15 types of serum bile acid profile. Results Compared with healthy control group, the serum concentration of cholic acid (CA), chenodeoxycholic acid (CDCA), glycocholic acid (GCA) increased and lithocholic acid (LCA) decreased significantly in NAFLD group (P<0.05). There was no obvious differences in serum concentration of deoxycholic acid (DCA), ursodeoxy cholic acid (UDCA), glycolitho cholic acid (GLCA), glycodeoxy cholic acid(GDCA), glycochenodeoxy cholic acid (GCDCA), glycoursodeoxy cholic acid (GUDCA), taurocholic acid (TCA), taurolitho cholic acid (TLCA), taurodeoxy cholic acid (TDCA), taurochodeoxy cholic acid (TCDCA), tauroursodeoxy cholic acid (TUDCA) (P>0.05). In NAFLD group, the serum content of DCA, GCA, GDCA, GCDCA, TCA, TCDCA were positively correlated with the serum level of ALT and AST. BMI (OR: 1.615; 95%CI: 1.224-2.131; P<0.05) and LCA (OR: 0.946; 95%CI: 0.906-0.987; P<0.05) were both associated with the risk of NAFLD. Among the bile acid profile, CA (AUC: 0.640), CDCA (AUC: 0.617)and GCA (AUC:0.634) had the higher diagnostic value for NAFLD. Conclusion The serum bile acid profile in NAFLD patients is significantly changed,which suggests that it may have positive value in diagnosis of NAFLD.

Key words: Nonalcoholic fatty liver disease, Bile acid profile, Non-invasive diagnosis

朱悦, 钱晓寒, 季国忠, 杨丽华. 血清胆汁酸谱在非酒精性脂肪性肝病患者中的表达及意义[J]. 肝脏, 2021, 26(11): 1279-1282.

ZHU Yue, QIAN Xiao-han, JI Guo-zhong, YANG Li-hua. The expression of serum bile acid profile in patients with nonalcoholic fatty liver disease[J]. Chinese Hepatolgy, 2021, 26(11): 1279-1282.

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