乙型肝炎肝硬化患者血清miR-122水平与肝纤维化程度的关系

摘要/Abstract

摘要： 目的探讨乙型肝炎肝硬化患者血清miR-122水平与肝纤维化程度的关系。方法纳入2022年5月至2023年12月南京市高淳人民医院收治的乙型肝炎肝硬化患者98例,同时纳入健康者40名。检测所有研究对象血清中 miR-122 表达水平及肝脏生化指标。 HBV-LC组中 S0、S1、S2、S3、S4的患者分别为19、22、23、18、16例。比较不同分期患者的miR-122及肝脏生化指标水平差异,并比较血清miR-122水平与纤维化标志物间的相关性。logistic 多元回归模型分析HBV-LC组患者肝纤维化的危险因素。结果 HBV-LC组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、甲胎蛋白(AFP)、γ-谷氨酰转肽酶(GGT)水平及 miR-122 表达水平分别为(59.80±13.60)U/L、(67.89±14.94)U/L、(19.07±4.20)μmol/L、(13.06±3.88)ng/mL、(76.46±20.31)U/L、(4.03±1.38),均高于对照组的(23.23±5.17)U/L、(21.22±4.98)U/L、(11.33±3.05)μmol/L、(3.54±1.12)ng/mL、(29.81±7.28)U/L、(1.25±0.37),差异均有统计学意义(P<0.05)。随着肝纤维化分期的增加,HBV-LC组患者 ALT、AST、TBil、AFP、GGT水平升高,miR-122 表达水平降低(P<0.05)。HBV-LC组患者血清miR-122 表达水平与AFP、AST、ALT、GGT、纤维化-4指数(FIB-4)、天冬氨酸氨基转移酶与血小板比值指数(APRI)、TBil和Forns指数均呈负相关(P<0.05)。logistic 多元回归分析提示酗酒和血清 miR-122表达水平较低是乙型肝炎肝硬化患者肝纤维化发生的危险因素(P<0.05)。miR-122表达水平诊断肝纤维化(S1~S4)的曲线下面积为0.939,灵敏度为94.7%,特异度为91.1%,显示出很高的诊断效能。结论乙型肝炎肝硬化患者血清miR-122水平随肝纤维化程度加重而降低,并与肝脏生化指标及纤维化标志物呈现出显著的相关性。酗酒以及低水平的血清miR-122表达是肝纤维化发展的危险因素。

关键词: 乙型肝炎, 肝硬化, miR-122, 肝纤维化

Abstract: Objective To investigate the association between serum miR-122 levels and the severity of liver fibrosis in hepatitis B-related cirrhotic (HBV-LC) patients. Methods A total of 98 blood samples were collected from HBV-LC patients from May 2022 to December 2023, forming the HBV-LC group. Meanwhile, blood samples from 40 healthy individuals were collected as the control group. Serum miR-122 expression levels and liver biochemical markers were tested in all participants. The HBV-LC group was divided into stage S0 (19 cases), S1 (22 cases), S2 (23 cases), S3 (18 cases), and S4 (16 cases) based on the degree of liver fibrosis. The differences in miR-122 and liver biochemical markers across different stages were compared. The correlation between serum miR-122 levels and fibrosis markers were analyzed. A logistic regression model was used to analyze the risk factors for liver fibrosis in the HBV-LC group, and a ROC curve was constructed. Results In the HBV-LC group, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alpha-fetoprotein (AFP), gamma-glutamyltransferase (GGT), and the expression level of miR-122 were (59.80±13.60) U/L, (67.89±14.94) U/L, (19.07±4.20) μmol/L, (13.06±3.88) ng/mL, (76.46±20.31) U/L, and (4.03±1.38), respectively, which were significantly higher than those of (23.23±5.17) U/L, (21.22±4.98) U/L, (11.33±3.05) μmol/L, (3.54±1.12) ng/mL, (29.81±7.28) U/L, (1.25±0.37) in the control group (P<0.05). With the progression of liver fibrosis stages, the levels of ALT, AST, TBil, AFP, GGT increased, whereas the miR-122 expression decreased (P<0.05). Serum miR-122 expression levels in the HBV-LC group were negatively correlated with AFP, AST, ALT, GGT, Fibrosis-4 Index (FIB-4), AST to Platelet Ratio Index (APRI), TBIL, and Forns index (P<0.05). The result of Logistic regression analysis indicated that alcohol consumption and lower serum miR-122 expression levels are risk factors for liver fibrosis in HBV-LC patients (P<0.05). The ROC curve analysis demonstrated that miR-122 expression levels have a high diagnostic efficiency for liver fibrosis (S1~S4) with an area under the curve of 0.939, a sensitivity of 94.7%, and a specificity of 91.1%. Conclusion The study shows that serum miR-122 levels decrease as liver fibrosis worsen in patients with hepatitis B virus-related cirrhosis and are significantly correlated with liver biochemical markers and fibrosis markers. Alcohol consumption and low serum miR-122 expression are important risk factors for the progression of liver fibrosis. Therefore, serum miR-122 expression levels may serve as an effective biomarker for assessing the degree of liver fibrosis in patients with HBV-LC and predicting disease progression, thus offering significant clinical application value.

Key words: Hepatitis B, Cirrhosis, miR-122, Liver fibrosis

孙颖, 孔燕, 赵丹妹, 陈应清. 乙型肝炎肝硬化患者血清miR-122水平与肝纤维化程度的关系[J]. 肝脏, 2024, 29(8): 924-928.

SUN Ying, KONG Yan, ZHAO Dan-mei, CHEN Ying-qing. The relationship between serum miR-122 levels and the degree of liver fibrosis in patients with hepatitis B-related cirrhosis[J]. Chinese Hepatolgy, 2024, 29(8): 924-928.

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