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溶性TREM2和PRO-C3作为生物标志物的能力,可以预测MASLD活动的变化

Charlotte Wilhelmina Wernberg^1,2, Vineesh Indira Chandran^3,4, Mette Munk Lauridsen²

¹Fibrosis, Fatty Liver and Steatohepatitis Research Center Odense (FLASH), Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.

JHEP reports : innovation in hepatology

|July 18, 2025

概括

新的非侵入性测试 (NIT) 在监测代谢功能障碍相关的脂肪肝疾病 (MASLD) 的治疗反应方面表现有前途. 可溶性TREM2,PRO-C3和HOMA-IR水平表明NAFLD活动评分 (NAS) 的改善.

科学领域:

肝病学肝病学是一种肝病学.
生物标志物发现发现
代谢疾病代谢疾病

背景情况:

代谢功能障碍相关的脂肪肝疾病 (MASLD) 管理依赖于生活方式的改变和新兴的药物治疗.
对于非侵入性测试 (NITs) 来有效监测治疗反应存在关键需求.
目前的评估方法通常涉及侵入性肝脏活检,突出显示了对替代品的需求.

研究的目的:

评估各种NIT能够反映MASLD患者组织学变化的能力.
确定特定的生物标志物是否可以在非酒精性脂肪性肝病 (NAFLD) 活动评分 (NAS) 中至少改善一点.
探索可溶性TREM2,原标记物和肝硬度测量的实用性,以评估治疗疗效.

主要方法:

173名2型糖尿病或严重肥胖患者接受了重复的肝脏活检和血液采样.
测量包括在骨髓细胞2 (sTREM2) 上表达的可溶性触发受体,原体标记物 (PRO-C3,PRO-C4,PRO-C6,PRO-C8,PRO-C18L),纤维扫描,FAST-score,以及对胰岛素抵抗的恒温模型评估 (HOMA-IR).
使用比较分析和多变量逻辑回归来评估生物标志物变化与NAS中的组织学变化.

主要成果:

根据NAS变化 (p=0.0001) 观察到sTREM2,PRO-C3,HOMA-IR和FAST-score的显著差异.
多变量分析显示,sTREM2 + PRO-C3和HOMA-IR预测了NAS的改善 (AUROC>0.75).
像FIB-4和NFS这样的传统得分并没有有效地反映NAS的改善 (AUROC <0.60).

结论:

sTREM2,PRO-C3和HOMA-IR是MASLD患者纳斯改善的有希望的指标.
这些生物标志物需要进一步研究,作为监测干预反应的潜在替代标志物.
结合sTREM2,PRO-C3或HOMA-IR可能会在临床实践中加强对NAS改善的监测.

关键词:

原体标记物原体标记物肝炎是一种肝炎.监控标记器是监控的标记器.新位生物标志物新位生物标志物非酒精性脂肪性肝炎的疾病.响应标志物是响应的标志物.序列肝脏活组织检查

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