Changes And Clinical Significance Of Serum Leptin,Adiponectin And Oxidative Stress In Patients With NAFLD/MAFLD

Objective:By enzyme-linked immunoassay,the levels of serum leptin and adiponectin in patients with NAFLD/MAFLD were detected,and by biochemical method,the levels of reduced glutathione and malondialdehyde were detected,and the correlation between the changes of leptin,adiponectin,oxidative stress with NAFLD/MAFLD was explored,so as to provide a new direction for early non-invasive diagnosis of non-alcoholic fatty liver disease.Methods:A total of 68 patients with NAFLD/MAFLD diagnosed in the physical examination center and inpatient department during July 2019 to July 2020 in our hospital were included in the study group.according to the results of abdominal color ultrasound,we can divided them into:mild,moderate and severe group.At the same time,22 non-NAFLD/MAFLD volunteers matched with age and gender were selected as the normal group.The general data,including height etc.were collected,then calculating the body mass index(BMI).Elbow venous blood was collected 12 hours after fasting.Liver function,blood lipid,serum uric acid,fasting blood glucose and fasting insulin were measured.Serum adiponectin and leptin were measured by ELISA)Serum glutathione and malondialdehyde were measured by biochemical method.SPSS22.0 statistical software was used for data analysis.Results:1.Compared with NC group,BMI,glucose metabolism index(FPG,FINS 、HOMA-IR),SUA,oxidative stress level(GSH,MDA),liver function index(ALT,GPRI,γ-GT,CHE),lipid metabolism index(TG,LDL-C),LEP and in NAFLD/MAFLD group were greatly higher(P < 0.05).There was no great difference in age and gender between two groups.2.The severity of fatty liver is related to serum lipid metabolism indexes(TG,LDL-C,HDL-C),liver function indexes(ALT,GPPR,γ-GT),FINS,GSH and the levels of BMI and HOMA-IR.Compared with NC group,there were significant differences in BMI,HOMA-IR,FINS,GSH and LDL-C in different degrees of fatty liver group,which was helpful to judge the severity of fatty liver.The GSH of moderate to severe fatty liver group was greatly higher than that of NC group and mild group,but there was no great difference in GSH between moderate and severe groups.The LEP of mild and moderate group was greatly higher than that of NC group,but there is no remarkable difference in LEP,ADPN and MDA among mild,moderate and severe groups.3.The level of serum adiponectin is negatively correlated with glucose metabolism index(FPG,FINS,HOMA-IR),TG,CHE and positively correlated with GPRI;The level of serum GSH is positively correlated with glucose metabolism index(FPG 、FINS,HOMA-IR),liver function indexes(APRI,GPRI,γ-GT),lipid metabolism indexes(TG,LDL-C),BMI;The level of serum MDA is positively correlated with TC、TG、LDL-C(P<0.05)。4.Multivariate regression analysis showed that the model with 7 independent variables was remarkable.When ALT was increased by 1U / L,the risk of fatty liver increased by 38.7%.When LDL was increased by 1mmol / L,the risk of fatty liver increased by 11.398 times,and when HDL-C increased by 1mmol / L,the risk of fatty liver decreased by 99.8%.For every increase of 1ug / ml of ADPN,the risk of fatty liver decreased by 27.5%,the risk of fatty liver increased by 1ng / ml;the risk of fatty liver increased by 97.2%,and the risk of fatty liver increased by 2.187 times when the IR increased by 1kg / ml.When BMI increased by 1kg / ml,the risk of fatty liver increased by 97.8%.5.According to ROC curve analysis,ADPN,GSH,LEP and MDA can effectively diagnose fatty liver,ADPN cutoff value for fatty liver diagnosis is ≤ 19.310ug/m L(sensitivity 0.588,specificity 0.727);GSH cutoff value is ≥ 53.827umol/L(sensitivity0588,specificity 0.727);LEP cutoff value is ≥ 9.445ng/m L(sensitivity 0.735,specificity0.727).The cutoff value of MDA in the diagnosis of fatty liver was ≥ 3.942nmol/m L(sensitivity 0.779,specificity 0.545).After the combined detection of ADPN,GSH,LEP and MDA,the sensitivity and specificity of diagnosis were increased.Conclusion:The serum levels of GSH,LEP and MDA in patients with NAFLD/MAFLD increased greatly,while the level of ADPN decreased.Combined detection of serum levels of ADPN,GSH,LEP and MDA may be used as serological markers for non-invasive diagnosis of NAFLD/MAFLD,so as to provide appropriate intervention when necessary.