实用肝脏病杂志2026，Vol.29Issue(1)：53-56,4.DOI:10.3969/j.issn.1672-5069.2026.01.014
NAFLD合并T2DM患者血清RBP-4、FGF21和NF-κB变化及其临床意义探讨
Implication of serum RBP-4,FGF21 and NF-κB levels in patients with NAFLD and concomitant T2DM
摘要
Abstract
Objective The aim of this study was to investigate implication of serum retinol binding protein 4(RBP-4),fibroblast growth factor 21(FGF21)and nuclear factor kappa B(NF-κB)levels in patients with nonalcoholic fatty liver disease(NAFLD)and concomitant type 2 diabetes mellitus(T2DM).Methods 257 patients with NAFLD,of which NAFLD and T2DM concomitant in 132 cases,were enrolled in our hospital between July 2022 and July 2025,and all underwent Fibrotouch for liver stiffness measurement(LSM).Serum RBP-4,FGF21 and NF-κB levels were assayed by ELISA.Multivariate Logistic regression analysis was applied to find risk factors for liver fibrosis,and receiver operating characteristic(ROC)curve was drawn for evaluating diagnostic efficacy.Results Serum RBP-4,FGF21 and NF-κB levels in patients with NAFLD and T2DM were(15.3±2.7)ng/mL,(314.3±33.6)pg/mL and(4.1±0.5)pg/mL,all significantly higher than[(11.5±1.7)ng/mL,(277.8±31.8)pg/mL and(2.7±0.6)pg/mL,respectively P＜0.05]in those with NAFLD;serum total cholesterol,RBP-4,FGF21 and NF-κB levels in 39 patients with moderate/severe liver fibrosis based on LSM were(6.2±1.4)mmol/L,(17.7±2.0)ng/mL,(326.9±35.3)pg/mL and(4.2±0.5)pg/mL,all significantly higher than[(5.7±1.3)mmol/L,(14.3±2.3)ng/mL,(309.0±31.6)pg/mL and(3.8±0.5)pg/mL,respectively,P＜0.05]in 93 patients with mild liver fibrosis;multivariate Logistic regression analysis showed that elevated serum RBP-4(OR=1.368),FGF21(OR=1.252)and NF-κB(OR=2.563)levels were all the independent risk factors for liver fibrosis in patients with NAFLD and T2DM(P＜0.05);ROC analysis demonstrated that the AUC was 0.910,with sensitivity of 97.4％and specificity of 72.0％,when serum RBP-4 level was combined with serum FGF21 and NF-κB levels in predicting moderate/severe liver fibrosis in patients with NAFLD and T2DM.Conclusion In patients with NAFLD and concomitant T2DM,increased serum RBP-4,FGF21 and NF-κB levels hint moderate-to-severe liver fibrosis existence,which might help clinicians screening liver fibrosis as early as possible.关键词
非酒精性脂肪性肝病/2型糖尿病/视黄醇结合蛋白4/成纤维细胞生长因子21/核因子κB/肝纤维化/诊断Key words
Nonalcoholic fatty liver disease/Type 2 diabetes mellitus/Retinol binding protein 4/Fibroblast growth factor 21/Nuclear factor κB/Liver fibrosis/Diagnosis引用本文复制引用
施凌云,吴彬彬,史艳利..NAFLD合并T2DM患者血清RBP-4、FGF21和NF-κB变化及其临床意义探讨[J].实用肝脏病杂志,2026,29(1):53-56,4.基金项目
江苏省卫生健康委员会科研面上项目(编号:M2023020) （编号:M2023020）
