Application value of serum ox-LDL and β2-GPⅠ in the diagnosis and disease assessment of metabolic-associated fatty liver disease

doi:10.3969/j.issn.1673-8640.2026.05.002

Abstract

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

CLC Number:

R446.1

CHEN Liyuan, CHE Jiaozi. Application value of serum ox-LDL and β₂-GPⅠ in the diagnosis and disease assessment of metabolic-associated fatty liver disease[J]. Laboratory Medicine, 2026, 41(5): 424-430.

Figures/Tables 11

References 23

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组别	例数	ox-LDL/（μg·L^-1）	β₂-GPⅠ/（mg·L^-1）	ox-LDL/β₂-GPⅠ比值/（μg·mg^-1）
MAFLD组	118	326.95±74.31	122.65±21.78	2.67±0.43
正常对照组	118	172.06±28.49	92.13±10.43	1.87±0.22
t值		21.142	13.729	17.992
P值		<0.001	<0.001	<0.001

组别	例数	ox-LDL/（μg·L^-1）	β₂-GPⅠ/（mg·L^-1）	ox-LDL/β₂-GPⅠ比值/（μg·mg^-1）
MAFLD组	118	326.95±74.31	122.65±21.78	2.67±0.43
正常对照组	118	172.06±28.49	92.13±10.43	1.87±0.22
t值		21.142	13.729	17.992
P值		<0.001	<0.001	<0.001

组别	例数	性别			年龄/岁	BMI/ （kg·m^-2）		病程/年		TG/ （mmol·L^-1）	LDL-C/（mmol·L^-1）
组别	例数	男/例	女/例		年龄/岁	BMI/ （kg·m^-2）		病程/年		TG/ （mmol·L^-1）	LDL-C/（mmol·L^-1）
轻度组	47	29	18		41.43±4.08	23.26±1.32		3.18±0.64		2.12±0.50	3.18±0.53
中度组	38	25	13		41.09±4.25	24.61±1.40^*		4.26±0.82^*		2.38±0.55^*	3.62±0.61^*
重度组	33	22	11		40.88±3.97	25.80±1.57^*#		5.02±0.89^*#		2.79±0.68^*#	4.28±0.74^*#
统计值		0.255			0.184	31.646		56.855		13.359	30.516
P值		0.880			0.832	<0.001		<0.001		<0.001	<0.001
组别	ALT/（U·L^-1）			TBA/（μmol·L^-1）			ox-LDL/（μg·L^-1）		β₂-GPⅠ/（mg·L^-1）		ox-LDL/β₂-GPⅠ比值/（μg·mg^-1）
轻度组	28.69±6.11			6.52±2.13			263.92±43.69		108.64±14.26		2.43±0.20
中度组	40.36±8.05^*			9.48±2.67^*			330.58±51.17^*		124.81±17.95^*		2.65±0.24^*
重度组	65.91±11.43^*#			15.03±3.81^*#			412.54±60.03^*#		140.12±21.10^*#		2.94±0.31^*#
统计值	188.586			86.641			82.219		31.523		41.169
P值	<0.001			<0.001			<0.001		<0.001		<0.001

组别	例数	性别			年龄/岁	BMI/ （kg·m^-2）		病程/年		TG/ （mmol·L^-1）	LDL-C/（mmol·L^-1）
组别	例数	男/例	女/例		年龄/岁	BMI/ （kg·m^-2）		病程/年		TG/ （mmol·L^-1）	LDL-C/（mmol·L^-1）
轻度组	47	29	18		41.43±4.08	23.26±1.32		3.18±0.64		2.12±0.50	3.18±0.53
中度组	38	25	13		41.09±4.25	24.61±1.40^*		4.26±0.82^*		2.38±0.55^*	3.62±0.61^*
重度组	33	22	11		40.88±3.97	25.80±1.57^*#		5.02±0.89^*#		2.79±0.68^*#	4.28±0.74^*#
统计值		0.255			0.184	31.646		56.855		13.359	30.516
P值		0.880			0.832	<0.001		<0.001		<0.001	<0.001
组别	ALT/（U·L^-1）			TBA/（μmol·L^-1）			ox-LDL/（μg·L^-1）		β₂-GPⅠ/（mg·L^-1）		ox-LDL/β₂-GPⅠ比值/（μg·mg^-1）
轻度组	28.69±6.11			6.52±2.13			263.92±43.69		108.64±14.26		2.43±0.20
中度组	40.36±8.05^*			9.48±2.67^*			330.58±51.17^*		124.81±17.95^*		2.65±0.24^*
重度组	65.91±11.43^*#			15.03±3.81^*#			412.54±60.03^*#		140.12±21.10^*#		2.94±0.31^*#
统计值	188.586			86.641			82.219		31.523		41.169
P值	<0.001			<0.001			<0.001		<0.001		<0.001

变量	β值	标准误	Wald值	P值	OR^①值（95%CI^②）
模型1
BMI	0.602	0.163	13.640	<0.001	1.826（1.427~2.336）
病程	0.511	0.167	9.361	<0.001	1.667（1.281~2.169）
TG	0.592	0.170	12.145	<0.001	1.808（1.420~2.303）
LDL-C	0.498	0.165	9.099	<0.001	1.645（1.265~2.139）
ALT	0.434	0.137	10.037	<0.001	1.543（1.187~2.007）
TBA	0.489	0.152	10.366	<0.001	1.631（1.202~2.214）
ox-LDL	0.435	0.124	12.296	<0.001	1.545（1.116~2.138）
β₂-GPⅠ	0.459	0.131	12.296	<0.001	1.583（1.104~2.270）
ox-LDL/β₂-GPⅠ比值	0.526	0.127	17.146	<0.001	1.692（1.255~2.281）
模型2
ox-LDL	0.422	0.131	10.373	<0.001	1.525（1.102~2.110）
β₂-GPⅠ	0.427	0.138	9.574	<0.001	1.533（1.051~2.235）
ox-LDL/β₂-GPⅠ比值	0.494	0.127	15.142	<0.001	1.639（1.218~2.206）

Application value of serum ox-LDL and β₂-GPⅠ in the diagnosis and disease assessment of metabolic-associated fatty liver disease

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Metrics

项目	AUC（95%CI）	最佳临界值	敏感性/%	特异性/%	约登指数
ox-LDL	0.736（0.676~0.796）	232.31 μg·L^-1	70.34	63.56	0.339
β2-GPⅠ	0.751（0.692~0.810）	101.75 mg·L^-1	71.19	70.34	0.415
ox-LDL/β2-GPⅠ比值	0.899（0.860~0.938）	2.18 μg·mg^-1	79.66	88.98	0.686

项目	AUC（95%CI）	最佳临界值	敏感性/%	特异性/%	约登指数
ox-LDL	0.754（0.689~0.819）	282.54 μg·L^-1	69.01	74.47	0.435
β₂-GPⅠ	0.745（0.679~0.811）	115.79 mg·L^-1	76.06	68.09	0.442
ox-LDL/β₂-GPⅠ比值	0.878（0.830~0.926）	2.57 μg·mg^-1	87.32	76.60	0.639

项目	AUC（95%CI）	最佳临界值	敏感性/%	特异性/%	约登指数
ox-LDL	0.740（0.662~0.818）	370.69 μg·L^-1	72.23	65.79	0.380
β₂-GPⅠ	0.769（0.694~0.844）	131.82 mg·L^-1	66.67	78.95	0.456
ox-LDL/β₂-GPⅠ比值	0.897（0.843~0.951）	2.78 μg·mg^-1	81.82	89.47	0.713

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