非酒精性脂肪性肝病病人血清长链非编码 NTF3-5水平与胰岛素抵抗的关系

目的 探讨长链非编码NTF3-5(Lnc-NTF3-5)在非酒精性脂肪性肝病（NAFLD）病人血清中的表达情况，并分析其与胰岛素抵抗的关系。方法 选取2019年12月至2020年12月来武汉市蔡甸区人民医院就诊并确诊为NAFLD病人115例为NAFLD组，根据疾病严重程度分为重度组（33例），中度组（40例），轻度组（42例）。同时选取55例健康者为健康对照组。收集一般资料，分别检测两组血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、谷氨酰基转移酶（GGT）、碱性磷酸酶（ALP），空腹血胰岛素（FINS），血糖（FPG）水平，根据FINS、FPG计算稳态模型胰岛素抵抗指数（HOMA-IR）及胰岛β细胞功能指数（HOMA-β）；采用实时荧光定量PCR法对血清中Lnc-NTF3-5表达水平进行检测，Pearson法分析Lnc-NTF3-5表达水平与上述肝功能指标和糖脂代谢指标的相关性；受试者操作特征（ROC）曲线评价血清Lnc-NTF3-5、HOMA-IR对NAFLD发生的...

The relationship between Lnc-NTF3-5 level and insulin resistance in patients with non-alcoholic fatty liver disease

Objective To investigate the expression of long non-coding NTF3-5 (Lnc-NTF3-5) in the serum of patients with non-alco. holic fatty liver disease (NAFLD) and to analyze its relationship with insulin resistance.Methods Totally 115 patients, who came toCaidian District People''s Hospital of Wuhan and were diagnosed with NAFLD during December 2019 to December 2020, were includ.ed as the NAFLD group. According to the severity of the disease, they were grouped into severe group (n=33), moderate group (n=40), and mild group (n=42). Meanwhile, 55 healthy people were chosen as the control group. The general data were collected and the twogroups were detected to collect the levels of serum total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltransfer.ase (GGT), alkaline phosphatase (ALP), fasting insulin (FINS), and fasting plasma glucose (FPG), respectively. The homeostasis modelinsulin resistance index (HOMA-IR) and pancreatic β cell function index (HOMA-β) were calculated according to FINS and FPG. Real-time fluorescent quantitative PCR method was performed to measure the expression level of Lnc-NTF3-5 in serum, and Pearson method was performed to analyze the correlation between the expression level of Lnc-NTF3-5 and the above-mentioned liver function indexes and glycolipid metabolism indexes. Receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic value of se.rum Lnc-NTF3-5 and HOMA-IR for the occurrence of NAFLD.Results The serum levels of Lnc-NTF3-5 (1.59 ± 0.37 vs. 1.01 ± 0.23) and HOMA-IR (2.67 ± 0.87 vs. 1.36 ± 0.48) in NAFLD group were higher than those in the healthy control group, and the levels of Lnc-NTF3-5 (2.02 ± 0.43 vs. 1.53 ± 0.37 vs. 1.32 ± 0.31) and HOMA-IR (3.75 ± 1.23 vs. 2.49 ± 0.81 vs. 1.98 ± 0.64) in NAFLD groups gradually increased with the severity of the disease with statistical significance (F=67.41, 66.02, P<0.05). The levels of TG [(3.23± 1.02) mmol/L vs. (1.13±0.31) mmol/L], TC [(5.15±0.88) mmol/L vs. (3.82±1.02) mmol/L], LDL-C [(3.28±0.63) mmol/L vs. (2.65±0.31) mmol/L], ALT [(55.33±18.34) U/L vs. (24.62±7.95) U/L], GGT [(33.21±10.62) U/L vs. (26.94±8.32) U/L], AST [(34.86±11.56) U/L vs. (22.32±4.26) U/L], FPG [(5.63±1.02) mmol/L vs. (4.99±0.88) mmol/L], FINS [(12.50±6.59) mU/L vs. (8.61±1.84) mU/L], and HOMA-β (4.92±0.80 vs. 4.61±0.67) in the NAFLD group were drastically higher than those in the control group, while the level of HDL-C [(1.03± 0.45) mmol/L vs.(1.32±0.32) mmol/L] in the NAFLD group was lower than that in the control group; the differences were statistically sig. nificant (t=2.49-14.92, P<0.05). Serum Lnc-NTF3-5 and HOMA-IR were inversely correlated with HDL-C(r=.0.54, P<0.05) (r=.0.61, P<0.05), but directly correlated with TG, TC, LDL-C, ALT, GGT, AST, FPG, FINS and HOMA-β(r=0.23, 0.22, 0.23, 0.21, 0.53, 0.19, 0.54, 0.55, 0.52, P<0.05) (r=0.45, 0.32, 0.27, 0.23, 0.52, 0.30, 0.52, 0.56, 0.53, P<0.05). The expression level of Lnc-NTF3-5 in serum of NAFLD patients was directly correlated with HOMA-IR (r=0.37, P<0.001). ROC results showed that the areas under the curve (AUC) predicted by Lnc-NTF3-5 and HOMA-IR for NAFLD patients were [0.85, 95% CI: (0.79, 0.90)] and [0.83, 95% CI: (0.76, 0.88)],respectively. The sensitivities were 72.17% and 61.74%, and the specificities were 89.09% and 98.18%. The AUC of the combinationof the two for NAFLD patients was [0.88, 95% CI: (0.82, 0.93)], the sensitivity 76.52%, and the specificity 96.36%.Conclusion The expression level of Lnc-NTF3-5 in the serum of NAFLD patients is directly correlated with HOMA-IR, and both are correlated with the liver function and glycolipid metabolism of the patients, which has important clinical significance.