摘要

目的 探讨非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)患者血清长链非编码RNA(long noncoding RNA,Lnc RNA)浆细胞瘤转化迁移基因1(plasmacytoma variant translocation gene 1,PVT1)表达水平与胰岛素抵抗和肝纤维化的相关性。方法 选择2020年8月~2022年4月西安市第九医院收治的143例NAFLD患者为观察对象(NAFLD组),选择同期性别、年龄相匹配的健康志愿者(肝功能检测、肝脏超声检查结果均正常)140例为对照组,收集入组人员资料及血清指标,采用RT-q PCR检测血清Lnc RNA PVT1表达,Pearson分析NAFLD患者血清Lnc RNA PVT1与胰岛素抵抗、肝纤维化指标的相关性,Logistic回归分析影响NAFLD患者发生肝纤维化的因素。结果 NAFLD组血清AST(52.21±11.33 U/L),ALT(42.36±8.42 U/L),FBG[8.23(5.31~10.90)mmol/L],HOMA-IR[2.31(1.52~3.95)],TC(5.31±1.05 mmol/L),TG(1.89±0.93 mmol/L),LDL-C(3.51±0.92 mmol/L),PCⅢ(121.55±21.32μg/L),CⅣ(78.56±15.42μg/L),LN(110.36±25.41μg/L)和HA水平(93.15±16.85μg/L)均高于对照组[24.35±8.53 U/L,28.62±6.35 U/L,5.34(9.65~6.71)mmol/L,1.68(1.26~2.61),4.26±0.53 mmol/L,1.23±0.35 mmol/L,2.82±0.75 mmol/L,95.34±12.63μg/L,54.34±8.37μg/L,84.21±16.55μg/L和82.43±14.26μg/L],而HDL-C(1.12±0.36 mmol/L)水平低于对照组(1.43±0.39 mmol/L),差异均有统计学意义(t/χ2=5.771~23.332,均P <0.001);NAFLD组患者血清Lnc RNA PVT1表达水平为1.79±0.52,高于对照组的1.05±0.18,差异有统计学意义(t=15.929,P <0.001),HOMAIR> 2.69的NAFLD患者血清Lnc RNA PVT1表达水平为2.18±0.45,显著高于HOMA-IR≤2.69患者血清Lnc RNA PVT1表达水平(1.46±0.48),差异有统计学意义(t=9.188,P <0.001);S0~S4期NAFLD患者血清Lnc RNA PVT1表达水平分别为1.41±0.35,1.72±0.40,2.01±0.33,2.31±0.32和2.62±0.24,且随着肝纤维化分期增加,血清Lnc RNA PVT1表达水平不断升高,差异有统计学意义(F=57.799,P <0.05);相关性分析显示,NAFLD患者血清Lnc RNA PVT1与FBG,HOMA-IR,TC,TG,LDL-C,PCⅢ,CⅣ,LN和HA呈正相关性(r=0.498,0.488,0.550,0.422,0.435,0.451,0.404,0.525,0.421,均P <0.001),与HDL-C呈负相关(r=-0.534,P <0.001);Logistic回归分析显示,HOMA-IR和Lnc RNA PVT1是NAFLD患者发生肝纤维化的独立危险因素(P <0.05)。结论 NAFLD患者血清Lnc RNA PVT1表达水平升高,与胰岛素抵抗、肝纤维化相关,可能成为评估NAFLD患者病情的指标。