Correlation Between Serum Total Bile Acid And Nonalcoholic Fatty Liver Disease

Objective This topic through the analysis of ningxia medical university general hospital,126 cases of patients with nonalcoholic fatty liver disease(NAFLD)serum total bile acid(associates)levels,as well as the joint Fibroscan(LSM)compared to liver tissue activity score(NAS)and hepatic fibrosis(HF)stage,to explore the serum total bile acid on nonalcoholic fatty hepatitis(NASH)and the value of clinical diagnosis of early liver fibrosis.Methods From December 2016 to June 2020,126 NAFLD patients were collected.Patients were divided into non-alcoholic hepatic steatosis(NAFL)group 47 cases according to liver tissue activity score(NAS score),79 cases of nonalcoholic steatohepatitis(NASH)group.Serum total bile acid(TBA)levels were measured by biochemical routine,Fibroscan(liver hardness value / LSM value),pathological biopsy evaluation of liver puncture NAS grading,fibrosis(F)stage and circulating enzyme method.Analyze the data with SPSS22.0software and draw a conclusion.Results(1)The majority of NAFLD patients were male,and the serum TBA levels were positively skewed in both males and females,among which 12% patients had abnormal glucose tolerance and 73% had triglyceride(TG)greater than 1.7mmol/L.(2)NASH compared with the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in NAFL patients,all patients in NASH group were higher than those in NAFL group,Differences were statistically significant(p<0.05);(3)TBA levels in NASH and NAFL groups were 5.0(3.2-6.8)μmol/L and 2.6(1.3-4.3),respectively significantly higher than NAFL group,The difference was considered statistically significant(p<0.05);(4)F0,F1 and F2-4levels of serum TBA,As fibrosis progresses,serum TBA levels increase,Differences were statistically significant(H=14.121,P< 0.05);(5)F0-F1 group compared with F2-F4 group of NASH patients,No or early stage of fibrosis NASH lower serum TBA levels than in patients undergoing prolonged fibrosis,TBA levels were(4.02±3.14)μmol/Land(8.51±6.49)μmol/L,respectively The difference was statistically significant(p<0.05);(6)Compared with NASH patients in F0-1 group and F2-4 group,liver hardness value of NASH patients with advanced fibrosis was higher,LSM value was(6.88±2.63)k Pa and(11.23±7.78)k Pa(p<0.05);(7)There was a positive correlation between serum TBA level and LSM value by Spearson correlation analysis(r=0.416,P<0.05);(8)The area under the curve of serum TBA and FIBROSCAN(LSM value)in NAFLD patients with NAS≥4 were 0.745 and 0.590,respectively.The sensitivity and specificity of serum TBA and LSM were 64.6% and 40.5%,and 76.6% and 80.9%.The area under the curve of the combination of TBA and LSM were0.750,and the sensitivity and specificity were 73.4% and 70.2%(p<0.05);(9)The areas under the curve of serum TBA and LSM value in NASH patients with F≥2 were 0.653 and 0.802.The sensitivity and specificity of serum TBA and LSM were 38.5% and 61.5%,and 93.1%and 93.1%.The areas under the curve of the combination of TBA and LSM were 0.798,and the sensitivity and specificity were 61.5% and 93.1%(p<0.05).Conclusion 1.The majority of NAFLD patients are male and overweight,and some patients have abnormal glucose tolerance.ALT and AST have certain diagnostic significance for NASH.2.Serum TBA had a certain specificity and sensitivity to predict NASH,and the cut-off value was 4.35μmol/L.FIBROSCAN combined with serum TBA was better for NASH auxiliary diagnosis.3.Fibroscan and combined serum TBA have certain specificity and sensitivity in the evaluation of NASH fibrosis with F≥2,while serum TBA alone has no great value in assisting in the diagnosis of NASH fibrosis.