| Background and objectives: The relationship between serum cytokeratin-18(CK-18)and hepatic steatosis in patients with non-alcoholic Fatty Liver Disease(NAFLD)was unclear.The aim of this study was to investigate the correlation of serum CK-18 M30 and CK-18 M65 with the hepatic steatosis in patients with magnetic resonance imaging proton density fat fraction(MRI-PDFF)diagnosed NAFLD,and the diagnostic value of CK-18M30 and CK-18 M65 on hepatic steatosis.Methods: NAFLD patients and non-NAFLD patients were included,and the basic information,clinical parameters and biochemical indicators were collected,including aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL),total cholesterol(TC),alkaline phosphatase(ALP),high-density lipoprotein(HDL),uric acid(UA),gama-glutamyl transferase(GGT),glycosylated hemoglobin(Hb A1c),triglycerides(TG),fasting blood glucose(FBG),low-density lipoprotein(LDL),fasting insulin(FINS),etc.The concentrations of serum CK-18 M30 and M65 were measured with enzyme linked immunosorbent assay(ELISA)methods.All participates were subjected to the MRI-PDFF examination and the degrees of hepatic steatosis were represented by the MRI-PDFF values.Patients with NAFLD were divided into the S1 group and S2 & S3 group according to the MRI-PDFF values.Statistical analyze were conducted by the SPSS 26.0 software,P<0.05 was considered as statistically significant.The clinical and biochemical indexes of all subjects were compared between different degrees of hepatic steatosis,and the correlation between serum CK-18 levels and the degree of hepatic steatosis was analyzed.Results: A total of 120 subjects were included in this study,including 40 in the non-NAFLD group,52 in the mild steatosis(S1)group,and 28 in the moderate & severe hepatic steatosis(S2&S3)group.Serum CK-18 M30 levels in S2&S3 group were significant different compared to the S1 group and health controls(P=0.037,P=0.005),but not different between S1 group and health controls(P=0.292).No significant differences of serum CK-18 M65 levels in each group.Spearman correlation coefficient analysis suggested that serum CK-18 M30 levels were positively associated with hepatic steatosis(r=0.3048,P<0.001),CK-18 M65 levels were poorly with hepatic steatosis.The AUROC values,sensitivity,specificity,and cut-off values of serum CK-18 M30 levels on diagnosing the hepatic steatosis were 0.611 and 0.666,53.75% and 60.71%,72.5% and79.35%,100.4U/L and 118.9U/L,respectively.Conclusion: Serum CK-18 M30 level was elevated in patients with hepatic steatosis,and was positively correlated with MRI-PDFF,indicating that the level of CK-18 M30 in NAFLD patients was associated with progress of hepatic steatosis;This study did not find a correlation between serum CK-18 M65 levels and hepatic steatosis.The association of serum CK-18 M30 with the degree of hepatic steatosis deserves further study. |
