细胞角蛋白18联合受控衰减参数对慢性乙肝合并代谢相关脂肪性肝病的诊断价值

目的 探讨血清细胞角蛋白18片段M 30(CK18M30)及片段M65(CK18M65)、血脂、受控衰减参数(controlled attenuation parameter,CAP)在慢性乙肝(chronic hepatitis B,CHB)合并代谢相关脂肪性肝病(metabolic-dysfunction-asso...

Diagnostic value of CAP,cytokeratin 18 and low-density lipoprotein cholesterolfor chronic hepatitis B with metabolic-dysfunction-associated fatty liver disease

Objective To investigate the diagnostic value of cytokeratin 18 M30(CK18M30)and M65(CK18M65),blood lipids and controlled attenuation parameter(CAP)in chronic hepatitis B(CHB)with metabolicdysfunction-associated fatty liver disease(MAFLD).Methods A total of 105 CHB patients concomitant with MAFLD patients were included from April 2019 to April 2020 were.Serum CK18M30,CK18M65 levels were measured by enzyme linked immunosorbent assay(ELISA);CAP was measured by Fibroscan;and ultrasonography was used to assessed the extent of hepatic steatosis.The index of serum CK18,blood lipids and CAP was analyzed by binary logistic regression,and the diagnostic value of the above indexes for CHB with MAFLD was evaluated by the areas under the receiver operating characteristic curve(AUC).Results ALT,AST,ALP,GGT,FBG,HDL,CK18M30 levels between MAFLD,CHB and CHB with MAFLD groups showed no significant statistical difference (P > 0.05). Compared to CHB group, the levels of CAP, TC, LDL and BMI were significantly higher in MAFLDand CHB with MAFLD groups(P < 0.05). CK18M65 level in CHB with MAFLD group was significantly higherthan in MAFLD and CHB groups(P < 0.05). The AUC of CK18M30, CK18M65, CAP, CAP-CK18M65, CAPCK18M65-TC and CAP-CK18M65-LDL for the diagnosis of CHB with MAFLD were 0.572(0.455 ~ 0.683),0.651(0.535 ~ 0.755), 0.737(0.626 ~ 0.830), 0.774(0.666 ~ 0.860), 0.797(0.691 ~ 0.879) and 0.837(0.728 ~0.915), respectively. Among the parameters, the combination of CAP, CK18M65 and LDL had the largest AUC andthe corresponding sensitivity and specificity were 0.811 and 0.719, respectively. Conclusion The combination ofCAP, CK18M65 and LDL has a superior diagnostic diagnastic value for CHB with MAFLD.