Determination of serum carbohydrate-deficient transferrin by a nephelometric immunoassay for differential diagnosis of alcoholic and non-alcoholic liver diseases
Determination of serum carbohydrate-deficient transferrin by a nephelometric immunoassay for differential diagnosis of alcoholic and non-alcoholic liver diseases
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通过比浊免疫分析法测定血清碳水化合物缺乏的转铁蛋白，用于酒精性和非酒精性肝病的鉴别诊断
DOI：
10.1016/j.cca.2018.06.040
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发表时间：
2018
期刊：
影响因子：
5
通讯作者：
Maruyama K.
中科院分区：
文献类型：
--
作者：
Nomura F;Kanda T;Seimiya M;Satoh M;Kageyama Y;Yamashita T;Yokosuka O;Kato N;Maruyama K.
背景碳水化合物缺乏的转铁蛋白是过量饮酒的生物标志物。本研究的目的是与γ谷氨酰转移酶相比，评估直接比浊免疫分析法对酒精性和非酒精性肝病鉴别诊断的诊断价值。方法采集305名受试者的血清样本，其中122名酒精性肝病患者和102名非酒精性肝病患者。血清中碳水化合物缺乏型转铁蛋白水平以占总转铁蛋白的百分比表示。结果酒精性肝病患者血清中碳水化合物缺乏型转铁蛋白水平百分比显着高于非酒精性肝病患者。碳水化合物缺乏型转铁蛋白在区分酒精性和非酒精性肝病方面比γ谷氨酰转移酶具有更好的特异性。8名酒精性肝病患者的γ谷氨酰转移酶水平正常，其中6名缺乏碳水化合物的转铁蛋白显着升高。另一方面，有25名非酒精性肝病患者的γ谷氨酰转移酶水平升高；在所有情况下，他们的碳水化合物缺乏转铁蛋白水平均在参考区间内。结论这种简单的碳水化合物缺乏转铁蛋白免疫测定可用于检测所谓的γ谷氨酰转移酶无反应饮酒者，也可排除过量饮酒在明显非酒精性肝病中的可能作用。需要进行大规模前瞻性研究来进一步证实碳水化合物缺乏转铁蛋白的诊断效用。
BackgroundCarbohydrate-deficient transferrin is a biological marker of excessive drinking. The aim of this study was to evaluate the diagnostic value of a direct nephelometric immunoassay for the differential diagnosis of alcoholic and non-alcoholic liver diseases in comparison with gamma glutamyl transferase.MethodsSerum samples were obtained from 305 subjects, including 122 patients with alcoholic and 102 cases with non-alcoholic liver diseases. Serum levels of carbohydrate-deficient transferrin were expressed as a percentage of total transferrin.ResultsSerum % carbohydrate-deficient transferrin levels were significantly higher in patients with alcoholic than with non-alcoholic liver diseases. Carbohydrate-deficient transferrin had better specificity than gamma glutamyl transferase to differentiate between alcoholic and non-alcoholic liver diseases.There were 8 alcoholic liver disease patients with normal gamma glutamyl transferase levels, and carbohydrate-deficient transferrin was significantly elevated in 6 of them. On the other hand, there were 25 non-alcoholic liver disease patients with elevated gamma glutamyl transferase levels; their carbohydrate-deficient transferrin levels were within the reference intervals in all cases.ConclusionThis simple carbohydrate-deficient transferrin immunoassay is useful to detect so-called gamma glutamyl transferase non-responding drinkers and also to exclude the possible role of excessive drinking in apparently non-alcoholic liver diseases. A large-scale prospective study is needed to further confirm the diagnostic utility of carbohydrate-deficient transferrin.