The Clinical Significance Of Serum CK18 In Coronary Atherosclerotic Heart Disease Combined With Non-alcoholic Fatty Liver Disease

Background and Objective Non-alcoholic fatty liver(NAFLD)is one of the most common causes of chronic liver injuries in the world,is tightly associated with metabolic syndrome and cardiovascular disease.Recent studies have shown that CK-18 may be closely associated with coronary heart disease(CAD).The purpose of this study is to investigate the following two points:(1)Based on the significant role of serum CK-18 in the detecting of NAFLD,and the relationship of NAFLD and CAD,we will clarify the changes of serum CK18 in patients with CAD and NAFLD compared to healthy people.(2)Compare the serum CK18 levels of patients with NAFLD and CAD combined NAFLD,and further discuss the interaction between CAD and NAFLD.Methods A total of 241 patients and hospitalized patients in Qingdao municipal hospital were included from September 2015 to July 2017.Subjects were divided into four groups: 52 patients with simple CAD group with an average age of(57.69±5.995)years;70 patients with NAFLD group with an average age of(53.57±6.243)years;90 patients with CAD and NAFLD group with an average age of(56.47±5.179)years;40 patients in the control group with an average age of(54.33±6.013)years.The sex ratio of subjects in the four groups was all 2:1.The serum levels of CK18-M30 and CK18-M65 were detected by enzyme-linked immunosorbent assay(ELISA),meanwhile,the serum indexes of ALT,AST,GGT,TG,TC,HDL-C,LDL-C and FBG were also detected.Statistical analysis of the results was carried out with corresponding statistical methods.(1)The levels of serum CK18-M30 and CK18-M65 in the above four groups were measured and there were significant differences between each two groups of the CK18-M30(P<0.01),but no significant difference were observed of the CK18-M30 levels between the NAFLD group and the CAD group(P=0.073)and the CK18-M65 levels between the NAFLD group and the NAFLD combined CAD group(P=0.214);(2)After Pearson correlation analysis,serum levels of CK18-M30 and CK18-M65 in patients with the NAFLD combined CAD group were significantly positively associated with serum ALT and AST.(The r values are 0.688,0.781,0.60,0.62,respectively,all the P < 0.05)ResultsConclusion(1)Serum CK18 levels was significantly increased in patients with NAFLD combined CAD and could be meaningful for the assessment of the severity in the patients with NAFLD combined CAD.(2)NAFLD combined CAD may aggravate the damage of target organ and accelerate the progression of disease.