Liver Int:生长分化因子15能够预测肝组织穿刺证实的非酒精性脂肪肝患者的晚期纤维化分期

2018-04-17 MedSci MedSci原创

研究结果表明,GDF15可作为诊断NAFLD晚期纤维化的一种新的生物标志物。

研究背景:本研究旨在探讨生长分化因子15 (GDF15)是否独立于胰岛素抵抗,来影响非酒精性脂肪性肝病(NAFLD)的组织学严重程度。

研究方法:在肝组织穿刺证实的NAFLD队列中,研究者采用酶联免疫吸附方法检测血清中的GDF15因子水平。

研究结果:在190例患者中(平均年龄为53±14岁,男性所占比例为52.1%),72例患者经肝穿证实为非酒精性脂肪肝(NAFL),78例患者经肝穿证实为非酒精性脂肪性肝炎(NASH)。NASH患者的血清GDF15水平显著高于正常对照组和NAFL组患者的血清GDF15水平(P分别为.010和.001)。晚期肝纤维化患者(≥F3)的血清GDF15水平相比其他患者显著增高(F0-2; P < .001)。在调整年龄、性别、体重指数、吸烟状况、高血压糖尿病、天门冬转移酶、血小板、白蛋白、胰岛素抵抗和低骨骼肌质量(比值比:4.27;95%置信区间:1.04-17.63)等参数后,在NAFLD患者中,GDF15最高四分之一水平,与晚期纤维化的风险显著相关;但是与NASH风险没有相关性。血清GDF15水平与肝脏硬度呈显著正相关(Spearman's rho:0.525;P < .001)。棕榈酸酯治疗可显著提高Kupffer细胞的GDF15 mRNA表达水平,但肝细胞中GDF15 mRNA表达水平增高不明显。在LX-2细胞中,GDF15治疗可促进平滑肌肌动蛋白和胶原I的表达,以及SMAD2和SMAD3的磷酸化。

研究结论:研究结果表明,GDF15可作为诊断NAFLD晚期纤维化的一种新的生物标志物。

原始出处:

Koo BK, Um SH, Seo DS, et al. Growth differentiation factor 15 predicts advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease. Liver Int, 2018, 38(4), 695-705. doi: 10.1111/liv.13587.

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    2018-04-29 songbq
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    2018-04-19 rgjl

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在获得持续病毒学应答的HCV患者中,研究观察到纤维化在长期随访中得到了显著改善。因此,建议在未达到肝硬化之前,通过生活方式的干预来减轻肥胖患者的体重,从而避免在病毒学治愈后继续存在晚期纤维化

J Gastroenterol Hepatol:sCD163和sMR与CHB患者的组织学炎症活动度和纤维化有关;抗病毒治疗后,两者水平均降低

巨噬细胞活化标志物-sCD163和sMR均与CHB患者的组织学炎症活动度和纤维化有关。两种血清标志物在抗病毒治疗后,均降低,同时肝CD163表达也降低。