Carbohydrate-deficient transferrin is a sensitive marker of alcohol consumption in fatty liver disease
Carbohydrate-deficient transferrin is a sensitive marker of alcohol consumption in fatty liver disease
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DOI：
10.1007/s12072-022-10298-8
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发表时间：
2022-01-20
影响因子：
6.6
通讯作者：
Ikejima，Kenichi
中科院分区：
文献类型：
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作者：
Morinaga，Maki;Kon，Kazuyoshi;Ikejima，Kenichi
背景：非酒精性脂肪性肝病(NAFLD)和酒精性/相关肝病(ALD)合并代谢综合征的患病率在全球范围内呈上升趋势。代谢综合征和过量饮酒协同加剧肝脏病理；因此，不受肝脏损伤或代谢综合征影响的饮酒特异性血清标志物对于评估饮酒至关重要。对脂肪性肝病患者糖缺乏转铁蛋白与总转铁蛋白的比值(%CDT)进行了评价，重点探讨其与代谢因素(UMIN000033550)的相关性。对代谢综合征相关因素、肝脏脂肪变性/肝僵硬与饮酒指标%CDT、γ-谷氨酰转移酶(GGT)、平均红细胞体积(MCV)进行多元线性回归分析。识别非饮酒者和轻度饮酒者的最佳界值为1.78%(敏感度为71.8%，特异度为83.7%，受试者工作特征曲线下面积为0.851)，显著高于GGT。诊断酗酒者的临界值为2.08%(敏感度为65.5%，特异度为86.8%，AUROC为0.815)。多元回归分析显示这一比例与体重指数呈负相关，而GGT和MCV则受多种因素影响，涉及肝损伤和血脂异常。结论%CDT与饮酒有很强的相关性，与肝损害、脂肪变性/僵硬或代谢综合征相关因素无关，是准确诊断NAFLD和ALD的有用的饮酒指标。
BackgroundThe prevalence of nonalcoholic fatty liver disease (NAFLD) and alcohol-associated/related liver disease (ALD) with metabolic syndrome is increasing globally. Metabolic syndrome and excessive alcohol consumption synergically exacerbate liver pathologies; therefore, drinking-specific serum markers unaffected by liver injury or metabolic syndrome are essential for assessing alcohol consumption. We evaluated the ratio of carbohydrate-deficient transferrin to total transferrin (%CDT) in patients with fatty liver disease, particularly focusing on its correlation with metabolic factors (UMIN000033550).MethodsA total of 120 patients with fatty liver disease, including ALD and NAFLD, were screened for alcohol misuse using the Alcohol Use Disorders Identification Test. Associations of metabolic syndrome-related factors and hepatic steatosis/liver stiffness with drinking markers, such as %CDT, gamma-glutamyl transferase (GGT), and mean corpuscular volume (MCV), were assessed using multiple linear regression analyses.Results%CDT significantly increased with 3–4 drinks/day. The optimal cutoff value for identifying non- to light drinkers was 1.78% (sensitivity, 71.8%; specificity, 83.7%; and area under the receiver operating characteristic curve [AUROC], 0.851), which was significantly higher than that for GGT. The cutoff value for identifying heavy drinkers was 2.08% (sensitivity, 65.5%; specificity, 86.8%; and AUROC, 0.815). Multiple regression analysis revealed that this proportion was negatively correlated with body mass index, whereas GGT and MCV were influenced by multiple factors involved in liver injury and dyslipidemia.Conclusions%CDT showed a strong correlation with alcohol consumption, independent of liver damage, steatosis/stiffness, or metabolic syndrome-related factors, indicating that it is a useful drinking marker for the accurate diagnosis of NAFLD and ALD.Graphical abstract