关键词: 氧化低密度脂蛋白, β₂-糖蛋白Ⅰ, 代谢相关脂肪性肝病, 病情

Abstract:

Objective To investigate the roles of serum oxidized low-density lipoprotein（ox-LDL），beta₂-glycoproteinⅠ（β₂-GPⅠ）and the ox-LDL/β₂-GPⅠ ratio in the diagnosis and disease assessment of metabolic-associated fatty liver disease（MAFLD）. Methods A total of 118 patients with MAFLD（MAFLD group）and 118 healthy subjects（healthy control group）were enrolled from Chengde Central Hospital from January 2022 to May 2024. The MAFLD patients were classified into mild group（47 cases），moderate group（38 cases）and severe group（33 cases）based on ultrasound results. The clinical data were collected，and serum triglyceride（TG），low-density lipoprotein cholesterol（LDL-C），alanine aminotransferase（ALT），total bile acid（TBA），ox-LDL and β₂-GPⅠ levels were determined. The ox-LDL/β₂-GPⅠ ratio was calculated. Spearman correlation analysis was used to evaluate the correlation between each index and the severity of MAFLD. Multivariate Logistic regression analysis was used to evaluate the influencing factors of MAFLD patients' condition. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of each index in diagnosing the condition of MAFLD patients. Results Serum ox-LDL，β₂-GPⅠ levels and ox-LDL/β₂-GPⅠ ratio in MAFLD group were higher than those in healthy control group（P<0.05）. The body mass index（BMI），disease duration，TG，LDL-C，ALT，TBA，ox-LDL，β₂-GPⅠ and ox-LDL/β₂-GPⅠ ratio in mild，moderate and severe groups were increased successively（P<0.001）. Serum ox-LDL，β₂-GPⅠ and ox-LDL/β₂-GPⅠ ratio were positively correlated with the severity of MAFLD（r values were 0.821，0.797 and 0.766，respectively，P<0.05）. After correcting for BMI，disease duration，TG，LDL-C，ALT and TBA using propensity score matching method，serum ox-LDL，β₂-GPⅠ and ox-LDL/β₂-GPⅠ ratio remained independent risk factors of the severity of MAFLD（P<0.05）. The areas under curves（AUC）of serum ox-LDL，β₂-GPⅠ and ox-LDL/β₂-GPⅠ ratio for diagnosing MAFLD were 0.736，0.751 and 0.899，respectively. For differentiating mild，moderate and severe MAFLD，the AUC were 0.754，0.745 and 0.878，respectively. For differentiating moderate and severe MAFLD，the AUC were 0.740，0.769 and 0.897，respectively. The AUC of the multi-index combined diagnostic model based on BMI，disease duration，TG，LDL-C，ALT，TBA，ox-LDL，β₂-GPⅠ and ox-LDL/β₂-GPⅠ ratio for differentiating mild，moderate and severe MAFLD and moderate and severe MAFLD were 0.962 and 0.968，respectively. Conclusions Serum ox-LDL，β₂-GPⅠ and ox-LDL/β₂-GPⅠ ratio in MAFLD patients are increased and are related to the severity of MAFLD，which may be used as the indicators for the diagnosis and disease assessment of MAFLD.

Key words: Oxidized low-density lipoprotein, Beta₂-glycoproteinⅠ, Metabolic-associated fatty liver disease, Disease condition