Authors

Jiabao Chang#, Xiling Fu, Jinlong Li, Yun Yin, Yueshuang Hu, Mongyin Yang

Departments

Department of Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, PR China

Abstract

Objective: To analyze the relationship between serum acid sphingomyelase (ASMase) and the degree of steatosis and related fibrosis in non-alcoholic fatty liver disease (NAFLD). 

Methods: From September 2018 to January 2019, 60 patients with NAFLD were treated in our hospital as an observation group. Another 30 healthy subjects were examined in our hospital. An ASMase enzyme-linked immunosorbent assay (ELISA) was used to analyze serum acid sphingomyelase, abdominal colour Doppler ultrasound was used to diagnose steatosis, and NSFLD, FibroScan and FIB-4 index were used to evaluate the related fibrosis. We investigated the relationship between serum acid sphingomyelase and the degree of steatosis and related fibrosis in NAFLD. 

Results: The neck circumference, waist circumference, diastolic blood pressure and systolic blood pressure of the observation group were significantly higher than those of the control group (P<0.001 or P<0.05), and the level of HbA1c, FPG, FFA, HDL-C, CHOL, HOMA-IR, LSM, CAP, WBC, ALB, UA, LDL-C, TG, GGT, AST and ALT in the observation group was significantly higher than that of the control group (P<0.001 or P<0.05). There was no significant difference in UREA, CREA and PLT between observation and control groups, but the serum ASMase of moderate to severe NAFLD in mild NAFLD was significantly higher than that in the control group, and the difference between moderate and severe NAFLD was significantly higher than that in mild NAFLD (P<0.05). There was a negative correlation between serum ASMase and WBC, CHOL and LDL-C (P<0.05) and a positive correlation with LSM, HbA1c, BMI, AST and HOMA-IR (P<0.05). Based on FIB-4 index, the level of ASMase in the progressive fibrosis group was significantly higher than that in both significant and non/mild fibrosis groups, and the level of ASMase in the advanced fibrosis group based on FibroScan was significantly higher than that in the significant and non/mild fibrosis groups; the difference was statistically significant (P<0 01 or P<0 05), and the level of ASMase in the progressive fibrosis group was significantly higher than that in both significant and non/mild fibrosis groups (P<0 01 or P<0 05). The ASMase level in the progressive fibrosis group was significantly higher than that in the significant fibrosis group (P<0 01 or P<0 05). The area under the diagnostic curve of serum ASMase in patients with NAFLD was 0.782, the area under the curve of diagnostic effect of serum ASMase in the diagnosis of NAFLD-related fibrosis was 0.712 (P<0.712), and the diagnostic effect of serum ASMase in patients with NAFLD-related fibrosis was higher than that in the advanced fibrosis group (P<0.869). 

Conclusion: Serum ASMase is related to the degree of NAFLD steatosis and related fibrosis. Serum ASMase is involved in the development of steatosis and fibrosis. It is an important factor in the pathogenesis of NAFLD and can be used as an independent marker for the diagnosis of this disease. 

Keywords

Serum acid sphingomyelase, non-alcoholic fatty liver disease, degree of steatosis, fibrosis.

DOI:

10.19193/0393-6384_2020_3_256