合并MAFLD的乙型肝炎肝硬化患者血清瘦素水平变化特点分析*

目的 探讨合并代谢相关脂肪性肝病(MAFLD)的乙型肝炎肝硬化患者血清瘦素(LP)水平变化特点。方法 在我院中法肝癌项目收集的标本库中,选择186例乙型肝炎肝硬化患者(Child-Pugh A级95例,B级51例和C级40例),在Child-Pugh A级患者中,合并MAFLD患者49例,未合并46例。采用ELISA法检测血清LP水平,采用多因素Logistic回归分析。结果 合并MAFLD的乙型肝炎肝硬化组血清甲胎蛋白(AFP)和LP水平分别为(2.1±1.3)ln ng/ml和(0.9±1.2)ng/ml,显著高于乙型肝炎肝硬化组分别为(1.5±1.1)ln ng/ml和(0.5±1.1)ng/ml,P＜0.05];以是否合并MAFLD为因变量,进行多因素Logistic回归分析,结果最终进入模型的因素有血清LP和AFP,发现LP每增加1个单位,发生MAFLD乙型肝炎LC的风险增加2.3倍(P＜0.05,OR=2.3),而血清AFP每增加1个单位,合并MAFLD的风险增加1.8倍(P＜0.05,OR=1.8);Child-Pugh A级、B级和C级乙型肝炎肝硬化患者血清LP水平无显著性差异(P＞0.05),而三组间血清AFP水平差异显著(P＜0.05)。结论 合并MAFLD的乙型肝炎肝硬化患者血清LP水平升高,未发现血清LP水平与乙型肝炎肝硬化严重程度相关,提示乙型肝炎肝硬化患者血清LP水平升高可能与合并代谢性因素相关。

Serum leptin level in patients with hepatitis B liver cirrhosis and concomitant metabolic associated fatty liver diseases

Objective The aim of this study was to investigate the changes of serum leptin level in patients with hepatitis B liver cirrhosis and concomitant metabolic associated fatty liver diseases (MAFLD). Methods The specimen from 186 patients with hepatitis B liver cirrhosis (including 95 cases of Child-Pugh class A, 51 cases of Child-Pugh class B and 40 cases of Child-Pugh class C) as the Sino-French Hepatocellular Carcinoma Project in our hospital were selected, and out of the patients with Child-Pugh class A, 49 patients had, and 46 had not concomitant MAFLD.Serum LP levels were determined by ELISA. The multivariate Logistic analysis was applied to reveal the risk factors for MAFLD occurrence. Results Serum AFP and LP levels in cirrhotics with MAFLD were (2.1±1.3)ln ng/ml and (0.9±1.2)ng/ml, significantly higher than (1.5±1.1)ln ng/ml and (0.5±1.1)ng/ml, respectively, P＜0.05] in cirrhotics without; the multivariate Logistic regression analysis was performed with the concomitant MAFLD as the dependent variable, the final factors found included serum LP and AFP levels, the risk for MAFLD occurrence increased 2.3 times for every increased 1 unit of serum LP level (P＜0.05, OR=2.3), and the risk for MAFLD increased 1.8 times for every increased 1 unit of serum LP level (P＜0.05, OR=1.8); there was no significant difference respect to serum LP level (P＞0.05), while there was significant differences respect to serum AFP level among cirrhotics with Child-Pugh class A, class B and class C (P<0.05). Conclusion Serum LP levels in patients with hepatitis B liver cirrhosis and concomitant MAFLD increase, but no correlation is found between serum LP levels and the severity of liver cirrhosis, suggesting that the elevated serum LP levels in patients with hepatitis B cirrhosis might be related to the combined metabolic factors.