Serum biomarkers of liver fibrosis identify globus pallidus vulnerability.
Serum biomarkers of liver fibrosis identify globus pallidus vulnerability.
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DOI：
10.1016/j.nicl.2023.103333
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发表时间：
2023
影响因子：
4.2
通讯作者：
Zahr, Natalie M.
中科院分区：
文献类型：
--
作者：
Kwong, Allison J.;Zahr, Natalie M.
苍白球高信号常出现于肝硬化患者。在这里，在一个大样本（n = 457）中计算了血清来源的肝纤维化标志物。血清纤维化切断评分确定苍白球易损性。较高的苍白质信号强度与感觉和运动障碍相关。首次报道了肝硬化前肝病患者的苍白质完整性受到影响。慢性肝病的中枢神经系统表现包括基底神经节结构的磁共振信号高。在这里，肝脏（血清纤维化评分）和大脑（区域t1加权信号强度和体积）完整性之间的关系在457个个体的样本中进行了评估，包括酒精使用障碍（AUD）患者、人类免疫缺陷病毒（HIV）感染者、AUD和HIV合并症患者和健康对照者。根据临界值确定肝纤维化如下：9.4% （n = 43）的队列中，天冬氨酸转氨酶与血小板比值指数（APRI）为bb0 0.7；28.0% （n = 128）的队列患者纤维化评分（FIB4）为> 1.5；非酒精性脂肪性肝病纤维化评分(NFS) > -1.4在30.2% （n = 138）的队列中。血清源性肝纤维化的存在与选择性基底节区（即尾状核、壳核和苍白球）结构的高信号强度有关。然而，苍白球的高信号强度解释了APRI（25.0%）和FIB4（23.6%）截止评分差异的重要部分。此外，在评估的区域中，只有苍白球显示出更大的信号强度和更小的体积之间的相关性（r = -0.44, p < 0.0001）。最后，苍白质信号强度越高，共济失调越严重（睁眼ρ = -0.23, p = 0.0002；闭眼ρ = -0.21, p = 0.0005）。该研究表明，肝纤维化的临床相关血清生物标志物，如APRI，可以识别易受苍白球病理影响的个体，并有助于姿势平衡问题。
Globus pallidus hyperintensities are often present in patients with liver cirrhosis. Here, serum-derived, liver fibrosis markers were calculated in a large (n = 457) sample. Serum fibrosis cutoff scores identified globus pallidus vulnerability. Higher pallidal signal intensities correlated with sensory and motor impairment. First time pallidal integrity is reported as affected in pre-cirrhotic liver disease. The CNS manifestation of chronic liver disease can include magnetic resonance (MR) signal hyperintensities in basal ganglia structures. Here, relations between liver (serum-derived fibrosis scores) and brain (regional T1-weighted signal intensities and volumes) integrity were evaluated in a sample of 457 individuals including those with alcohol use disorders (AUD), people living with human immunodeficiency virus (HIV), those comorbid for AUD and HIV, and healthy controls. Liver fibrosis was identified from cutoff scores as follows: aspartate aminotransferase to platelet ratio index (APRI) > 0.7 in 9.4% (n = 43) of the cohort; fibrosis score (FIB4) > 1.5 in 28.0% (n = 128) of the cohort; and non-alcoholic fatty liver disease fibrosis score (NFS) > -1.4 in 30.2% (n = 138) of the cohort. Presence of serum-derived liver fibrosis was associated with high signal intensities selective to basal ganglia (i.e., caudate, putamen, and pallidum) structures. High signal intensities in the pallidum, however, explained a significant portion of the variance in APRI (25.0%) and FIB4 (23.6%) cutoff scores. Further, among the regions evaluated, only the globus pallidus showed a correlation between greater signal intensity and smaller volume (r = -0.44, p <.0001). Finally, higher pallidal signal intensity correlated worse ataxia (eyes open ρ = -0.23, p =.0002; eyes closed ρ = -0.21, p =.0005). This study suggests that clinically relevant serum biomarkers of liver fibrosis such as the APRI may identify individuals vulnerable to globus pallidus pathology and contribute to problems with postural balance.
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影响因子：
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作者：
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通讯作者：
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通讯作者：
RASMUSSEN, T
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通讯作者：
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