The Preliminary Search On The Expression Of Cytokeratin (CK) 18 In Nonalcoholic Fatty Liver Disease With Metabolism Syndrome

Background and Goals:Cytokeratin (CK) 18 was found increasing in different kinds of liver diseases include nonalcoholic fatty liver disease(NAFLD) as a marker of hepatocyte apoptosis,Metabolic syndrome(MS) and its components(hypertension, adiposity, hyperlipidemia and so on) are the risk factors of NAFLD. We hypothesized that MS and its components had value in predicting the severe of NAFLD, through compare the level of CK-18 between the groups of NAFLD with and without MS.Method:we accumulated patients with NAFLD and without fatty liver disease from health examination center in second affiliated hospital Zhejiang university college of medicine. Also we together hepatocirrhosis hepatocellular carcinoma petients in hospital. These patients were underwent anthropometry (height,weight, Body Mass Index BMI,and blood pressure), laboratory tests, including alanine (?) aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP), y-glutamyltransfemse(GGT), serum lipid. Serum level of CK-18 was measured too.Results:(1)57 NAFLD,60 non fatty liver disease,28 hepatocirrhosis hepatocellular carcinoma petients were admitted. In NAFLD group,there were 89.5% males, and 10.5% females,65% patients'age were above 40,67% patients had the history of NAFLD less than 3years.(2)The levels of ALT,AST,GGT,ALP were significantly higher in patients with NAFLD than patients without fatty liver disease. The levels of ALT,AST had statistical significance in NAFLD patients with and without MS (31.86±13.01 U/L vs 23.33±10.02U/L, P<0.05)(26.07±7.98 U/L vs 19.56±5.91U/L, P<0.05).While the level of total bilirubin and albumin had no statistical significance between patients with and without NAFLD.(3)In NAFLD group, there were only 3.5% patients had no abnormal of MS components,28.1% patients had at least one MS component,43.9% patients had two MS component3,24.6% patients got MS. BMI,FPG,TG,HDL-C had statistical significance between patients with NAFLD and without fatty liver disease. In NAFLD group, patients who's serum level of TG>110mg/dL had significantly higher levels of CK-18 compared with those of TG<110mg/dL (33.55±20.92ng/ml vs 53.76±47.19ng/ml, P<0.05),it also found statistical significance of CK-18 level between groups with normal HDL-C and abnormal HDL-C in NAFLD patients (31.75±1.57 ng/ml vs 48.68±43.16ng/ml, P<0.01)(4) The serum levels of CK-18 were significantly higher in thte NAFLD patients and hepatocirrhosis hepatocellular carcinoma patients than in non NAFLD (19.84±3.68 vs47.60±41.95 vs89.05±122.16ng/ml, P<0.01)(5)The levels of CK-18 were significantly higher in the group of NAFLD with MS than the group of NAFLD without MS (65.55±32.33ng/ml vs 42.40±31.61 ng/ml, P, P<0.05).while we did not find statistical significance of the level of CK-18 among NAFLD patients contains one MS component,two MS components and with MS.(6) The levels of CK-18 were significantly higher in the group of NAFLD have abnormal liver function than the group of NAFLD have normal liver function (41.73±27.80ng/ml vs 87.05±49.86ng/ml,P<0.05).Conclusions:(1)The serum level of CK-18 was significantly higher in the NAFLD patients, it should be a efficiency non-invasive marker for NAFLD.(2) The serum level of CK-18 was significantly higher in the NAFLD patients with MS than without MS, MS may have value in predicting the severity of NAFLD.(3) The serum level of CK-18 was significantly higher in the NAFLD patients who's liver function were abnormal than those have normal liver function.Liver function test may have contribution to predict the severity of NAFLD.(4)The level of BMI,FPG,TG(triglyceride),HDL-C(high density lipoprotein-cholesterol) were significantly higher in the NAFLD patients,BML,FPG,TG,HDL-C hadve close relationship with NAFLD,especially BMI and TG.