Abstract: Objective To investigate the changes and clinical value of serum pancreatic lipase (P-LIP) and angiopoietin-like protein 4 (ANGPTL4) in non-alcoholic fatty liver disease (NAFLD).Methods A total of 128 NAFLD patients admitted to this hospital from February 2018 to October 2020 were selected as the study group, and 120 healthy patients who underwent physical examination in the hospital during the same time period were selected as the control group. The serum P-LIP and ANGPTL4 levels of the two groups of study subjects were compared. the NAFLD patients were divided into mild group (69 cases), moderate group (36 cases) and severe group (23 cases) based on abdominal ultrasound examination, and the different severity levels were compared Serum P-LIP and ANGPTL4 levels in NAFLD patients. Make receiver operating characteristic curve (ROC) to analyze the diagnostic efficacy of serum P-LIP, ANGPTL4 and their combination for NAFLD.Results The systolic blood pressure, diastolic blood pressure, alanine aminotransferase (ALT), aspartate aminotransferase (AST), phosphocreatine kinase (CK) and total cholesterol (TC) in the study group were significantly higher than those in the control group (t=5.375, 7.669, 17.110, 9.447, 12.644, 12.213, all P<0.05). The serum P-LIP level in the study group was (27.5±8.1) U/L, which was significantly lower than the control group (38.1±9.8) U/L (t=9.308, P<0.05), and the serum ANGPTL4 level in the study group was (172.7±75.3) ng/mL, which was significantly lower It was higher than the control group (145.3±65.4) ng/mL (t=3.051, P<0.05). The serum P-LIP and ANGPTL4 levels of NAFLD patients with different severity levels were statistically different (t=11.357, 7.518, P<0.05). The serum P-LIP of NAFLD patients in the severe group was significantly lower than that in the mild group and the moderate group (t=4.295, 2.467, P<0.05). Serum P-LIP of NAFLD patients in the severe group was significantly lower than that in the mild group (t=2.009, P<0.05); serum NGPTL4 in the severe group of NAFLD patients was significantly higher than that in the mild and moderate groups (t=4.417, 2.047, P<0.05), and serum ANGPTL4 in the moderate group of NAFLD patients was significantly higher than the mild group (t=2.332, P<0.05). ROC analysis showed that the best cut-off points for the diagnosis of NAFLD patients by serum P-LIP and ANGPTL4 were 33.6 U/L and 164.2 ng/mL, respectively. The specificity of the combination of the two was 96.7%, which was higher than that of serum P-LIP and ANGPTL4. The specificity of diagnosis alone (70.8%, 60.8%), the area under the curve (AUC) of the combined diagnosis of serum P-LIP and ANGPTL4 for NAFLD patients was 0.874, which was significantly higher than the AUC (0.718, 0.663) (Z=4.015, 4.042, P=0.003, 0.001), and the combination of serum P-LIP and ANGPTL4 showed good consistency between the diagnosis of NAFLD patients and the results of abdominal ultrasound examination (Kappa=0.715, P=0.008).Conclusion The combined detection of serum P-LIP and ANGPTL4 has a higher diagnosis of NAFLD and can be used as an important reference index for the diagnosis of NAFLD.

Key words: Serum pancreatic lipase, Angiopoietin-like protein 4, Non-alcoholic, Fatty liver disease