关键词: 非酒精性脂肪性肝病, 慢性乙型肝炎, Maresin-1, 肝纤维化分期, 肝脂肪变程度

Abstract: Objective To compare the clinical data of nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B (CHB), and to explore the relationship between Maresin-1 (MaR1) and liver histological features of NAFLD patients, including liver fibrosis stages, and liver inflammation and fatty liver degrees. Methods From January 2021 to February 2022, 126 NAFLD patients (NAFLD group) were selected, including 75 males and 51 females, with an average age of (44.3±8.4) years. In the same period of time, 120 patients with CHB (CHB group) were selected as the control group, including 63 males and 57 females, aged (41.6±7.3) years. The diagnosis of NAFLD and CHB met the requirements. The clinical data of NAFLD group and CHB group were compared, and the changes of MaR1 level in patients with NAFLD were analyzed. receiver operator characteristic curve (ROC) was constructed, The value of area under the curve (AUC) was calculated, and the cutoff point of serum MaR1 for NAFLD patients with different liver histology was analyzed. Results BMI of NAFLD group and CHB group was (27.3±3.4) mg/m² and (22.5±2.7) mg/m², the difference was statistically significant (P<0.05). Compared with CHB group [(4.8±1.0) mmol/L], FBG in NAFLD group increased significantly [(5.7±1.0) mmol/L, P<0.05]. The levels of ALT, AST, TC, TG, UA, LDL and Scr in NAFLD group were (38.0±5.2) U/L, (34.8±5.0) U/L (5.0±0.7) mmol/L, (2.0±0.5) mmol/L, (5.2±0.6) mmol/L, (3.4±0.5) mmol/L and (70.5±14.6) μmol/L, compared with CHB group [(26.8±4.3) U/L, (23.0±4.1) U/L, (4.6±0.6) mmol/L, (1.2±0.4) mmol/L, (4.7±0.4) μmol/L, (3.0±0.5) and (63.3±12.9) μmol/L, the difference was statistically significant (P<0.05). The HDL levels in NAFLD group and CHB group were (1.1±0.3) mmol/L and (1.4±0.4) mmol/L, and the difference was statistically significant (P<0.05). Compared with CHB group [(79.1±5.5) pg/mL], MaR1 in NAFLD group decreased significantly [(63.6±4.3) pg/mL, P<0.05]. The liver fibrosis stages were F0 stage in 18 cases, F1 stage in 26 cases, F2 stage in 44 cases, F3 stage in 23 cases and F4 stage in 15 cases. The MaR1 of each liver fibrosis was (78.8±5.7) pg/mL, (73.0±5.0) pg/mL, (65.2±4.4) pg/mL, (60.4±4.5) pg/mL and (57.0±4.4) pg/mL, respectively, the difference was statistically significant (P<0.05). The degree of liver inflammation was grade 1 in 29 cases, grade 2 in 62 cases, grade 3 in 23 cases and grade 4 in 12 cases, the inflammatory degree of each liver tissue MaR1 was (75.6±5.4) pg/mL, (66.9±4.8) pg/mL, (60.6±5.3) pg/mL and (50.2±5.0) pg/mL, respectively, the difference was statistically significant (P<0.05). In patients with NAFLD, the degree of hepatic steatosis was S0 in 25 cases, S1 in 46 cases, S2 in 35 cases and S3 in 20 cases. The degree of hepatic steatosis MaR1 was (77.8±5.2) pg/mL (72.4±5.1) pg/mL, (64.0±4.4) pg/mL and (61.3±4.6) pg/mL, respectively, the difference was statistically significant (P<0.05). The cut-off points of serum MaR1 were 68.2 pg/mL, 70.5 pg/mL and 66.6pg/mL, respectively, when evaluating liver fibrosis stage ≥F2, liver tissue inflammatory activity grade ≥2 and liver steatosis degree ≥S2, the corresponding AUC values are 0.78, 0.77 and 0.87, respectively. Conclusion Serum MaR1 level in patients with NAFLD decreased significantly, which can be used to predict and prevent the occurrence of NAFLD.

Key words: Nonalcoholic fatty liver disease, Chronic hepatitis B, Stage of hepatic fibrosis, Degree of hepatic steatosis