脂肪酶、脂蛋白(a)及脂蛋白相关磷脂酶A2对非酒精性脂肪性肝病早期心血管损伤诊断的价值

肝脏 ›› 2025, Vol. 30 ›› Issue (9): 1200-1203.

脂肪酶、脂蛋白(a)及脂蛋白相关磷脂酶A2对非酒精性脂肪性肝病早期心血管损伤诊断的价值

杨森, 吴春芳, 章杨杨, 成思, 石磊, 王丽丽

201203 上海上海中医药大学附属曙光医院检验科(杨森,章杨杨,成思,石磊),核医学(王丽丽);200040 上海静安区中心医院检验科(吴春芳)

收稿日期:2024-11-29 出版日期:2025-09-30 发布日期:2025-11-05
通讯作者: 王丽丽,Email: sg_wll0516@hotmail.com;石磊,Email: 13818226306@139.com
作者简介:共同第一作者:吴春芳

The value of lipase, lipoprotein (a) and lipoprotein-associated phospholipase A2 in the diagnosis of early cardiovascular injury in patients with non-alcoholic fatty liver disease

YANG Sen¹, WU Chun-fang², ZHANG Yang-yang¹, CHENG Si¹, SHI Lei¹, WANG Li-li³

1. Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
2. Department of Clinical Laboratory, Jing'an District Centre Hospital of Shanghai, Shanghai 200040, China;
3. Department of Nuclear Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

Received:2024-11-29 Online:2025-09-30 Published:2025-11-05
Contact: WANG Li-li, Email: sg_wll0516@hotmail.com; SHI Lei, Email: 13818226306@139.com

摘要/Abstract

摘要： 目的探讨脂肪酶、脂蛋白(a)及脂蛋白相关磷脂酶A2对非酒精性脂肪性肝病( NAFLD) 早期心血管损伤的诊断价值。方法纳入2024年1月至2024年6月上海曙光医院收治的NAFLD 患者100例及同期健康体检者100名。对两组一般资料及实验室指标进行比较。分析3项指标联合检测对NAFLD早期心血管损伤的诊断效能。结果 NAFLD组脂肪酶为(50.58±11.52)mmol/L、脂蛋白(a)为(93.50±32.57)mmol/L、脂蛋白相关磷脂酶A2为(551.15±67.47)mmol/L,均明显高于对照组的(40.25±13.67)、(32.77±16.68)、(231.28±23.22)mmol/L,差异有统计学意义(t=8.456、5.763、0.843,P<0.05)。Logistic多因素回归分析结果显示,性别、年龄、高血压、糖尿病与NAFLD不相关,而脂肪酶(β=11.25,P=0.02)、脂蛋白(a)(β=9.56,P=0.01)及脂蛋白相关磷脂酶A2(β=13.46,P<0.01)均与NAFLD相关,其中脂蛋白相关磷脂酶A2的相关系数最高。脂肪酶、脂蛋白(a)及脂蛋白相关磷脂酶A2联合检测对NAFLD心血管损伤的诊断灵敏度为82.33%、特异度为64.27%、AUC为0.725,显著高于单独检测,差异有统计学意义(P<0.05)。结论脂肪酶、脂蛋白(a)及脂蛋白相关磷脂酶A2均为 NAFLD 的独立危险因素,3者联合检测在评估 NAFLD 病变时价值更高。

关键词: 非酒精性脂肪性肝病, 脂肪酶, 脂蛋白(a), 脂蛋白相关磷脂酶A2

Abstract: Objective To investigate the correlation of lipase, lipoprotein (A) and lipoprotein-associated phospholipase A2 with early cardiovascular injury in patients with non-alcoholic fatty liver disease (NAFLD). Methods A total of 100 NAFLD patients (study group) and 100 healthy subjects (control group) were collected. Their general data and laboratory indicators were compared and the correlation between the indexes of the study group and the NAFLD group were studied. At the same time, the diagnostic efficacy of a combined detection with three indicators in the diagnosis of early cardiovascular injury in NAFLD was analyzed. Results The levels of lipase (50.58±11.52 mmol/L), lipoprotein (a) (93.50±32.57 mmol/L), and lipoprotein-associated phospholipase A2 (551.15±67.47 mmol/L) in the study group were significantly higher than those in the control group, with statistically significant differences (P<0.05). Logistic multivariate regression analysis showed that gender, age, hypertension, and diabetes were not associated with NAFLD, while lipase (β=11.25, P=0.02), lipoprotein (a) (β=9.56, P=0.01), and lipoprotein-associated phospholipase A2 (β=13.46, P=0.00) were all significantly associated with NAFLD, and lipoprotein-associated phospholipase A2 having the highest correlation coefficient. The combined detection of lipase, lipoprotein (a), and lipoprotein-associated phospholipase A2 showed a sensitivity of 82.33%, an accuracy of 64.27%, and an AUC of 0.725 for the diagnosis of NAFLD-related cardiovascular injury, which was significantly higher than that of individual detection, with statistically significant differences (P<0.05). Conclusion Lipase, lipoprotein (A) and lipoprotein-associated phospholipase A2 are independent risk factors for NAFLD. A combined detection of these three is more valuable in evaluating NAFLD lesions.

Key words: Non-alcoholic fatty liver disease, Lipase, Lipoprotein (a) , Lipoprotein-associated phospholipase A2

杨森, 吴春芳, 章杨杨, 成思, 石磊, 王丽丽. 脂肪酶、脂蛋白(a)及脂蛋白相关磷脂酶A2对非酒精性脂肪性肝病早期心血管损伤诊断的价值[J]. 肝脏, 2025, 30(9): 1200-1203.

YANG Sen, WU Chun-fang, ZHANG Yang-yang, CHENG Si, SHI Lei, WANG Li-li. The value of lipase, lipoprotein (a) and lipoprotein-associated phospholipase A2 in the diagnosis of early cardiovascular injury in patients with non-alcoholic fatty liver disease[J]. Chinese Hepatolgy, 2025, 30(9): 1200-1203.

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