围产期奶牛脂肪肝生物标志物受试者工作特征曲线分析

doi:10.16431/j.cnki.1671-7236.2022.01.038

摘要/Abstract

摘要： [目的] 通过受试者工作特征（receiver operating characteristic，ROC）曲线筛选诊断脂肪肝生物标志物的最佳临界值。[方法] 随机采集77头产后7 d中国荷斯坦奶牛血清，测定生理生化指标。根据Reid方程计算的Y值将奶牛分为正常组（Y>1）和脂肪肝组（Y<1），比较两组奶牛血清指标的差异，并与Y值进行相关性分析，筛选组间差异与相关性显著的指标作为生物标志物，用ROC曲线评估生物标志物的AUC值、诊断敏感性与特异性和最佳临界值。将Reid方程诊断脂肪肝的准确率作为标准，用非酯化脂肪酸（NEFA）、谷草转氨酶（AST）的最佳临界值检测461头奶牛患脂肪肝的情况。[结果] 生理生化检测结果表明NEFA、葡萄糖（Glu）、AST、谷丙转氨酶（ALT）在2组间差异极显著（P<0.01），总蛋白（TP）组间差异显著（P<0.05），其他指标两组间无显著差异（P>0.05）；NEFA、Glu、AST、ALT、TP、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、胰岛素（Ins）、胰高血糖素（Gln）与Y值显著相关（P<0.05），可作为生物标志物；NEFA、AST、ALT和Gln的AUC值>0.5能准确诊断脂肪肝，诊断敏感性分别为81.8%、72.7%、63.6%和54.5%，特异性分别为92.8%、89.4%、84.8%和69.7%，最佳临界值分别为471.74 μmol/L、95.50 U/L、46.50 U/L和64.60 ng/mL。用NEFA、AST和NEFA+AST最佳临界值诊断脂肪肝的准确率分别高达89.96%、73.49%和69.08%。Y值诊断发病率为54.01%，NEFA、AST、NEFA+AST诊断出的发病率分别为48.59%、39.70%和37.31%。[结论] NEFA、AST、ALT和Gln可用于快速、准确地诊断脂肪肝。

关键词: 围产期奶牛; 脂肪肝; 诊断; 生物标志物; 受试者工作特征曲线

Abstract: [Objective] The best cut-off value of biomarkers for the diagnosis of fatty liver was screened by the receiver operating characteristic (ROC) curve. [Method] Serum was randomly collected from 77 Chinese Holstein dairy cows 7 days postpartum to determine physiological and biochemical indicators. According to the Y value calculated by the Reid equation, the cows were divided into normal group (Y>1) and fatty liver group (Y<1), and the differences in serum indexes of cows in two groups were compared, and the correlation analysis with Y value was performed to screen the group. The indicators with significant differences and correlations are used as biomarkers, and the receiver operating characteristic (ROC) curve was used to evaluate the AUC value, diagnostic sensitivity and specificity, and the best cut-off value of the biomarker. Finally, the accuracy of the Raid equation in diagnosing fatty liver was used as the standard, and the best cut-off value of NEFA and AST was used to detect the fatty liver of 461 dairy cows. [Result] Physiological and biochemical test results showed that NEFA, glucose(Glu), AST, alanine amino transferase(ALT) between two groups had extremely significant difference (P<0.01), total protein(TP) had significant difference (P<0.05), and other indicators had no significant difference (P>0.05). NEFA, Glu, AST, ALT, TP, triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), insulin(Ins), glucagon(Gln) were significantly correlated with Y value and could be used as biomarkers. The AUC value of NEFA, AST, ALT and Gln could be more than 0.5. Accurately diagnose fatty liver, the diagnostic sensitivity were 81.8%, 72.7%, 63.6% and 54.5%, the specificity were 92.8%, 89.4%, 84.8% and 69.7%, the best cut-off value were 471.74 μmol/L, 95.50 U/L, 46.50 U/L and 64.60 ng/mL, respectively. The accuracy of using NEFA, AST and NEFA+AST best cut-off values to diagnose fatty liver were 89.96%, 73.49% and 69.08%, respectively. The incidence rate diagnosed by the Y value was 54.01%, and the incidence rates diagnosed by NEFA, AST and NEFA+AST were 48.59%, 39.70% and 37.31%, respectively. [Conclusion] NEFA, AST, ALT and Gln could be used to quickly and accurately diagnose fatty liver.

Key words: perinatal dairy cows; fatty liver; diagnosis; biomarker; receiver operating characteristic curve

中图分类号:

S854.4

卢立叶, 牛富贵, 王中华, 林雪彦, 王云, 侯秋玲. 围产期奶牛脂肪肝生物标志物受试者工作特征曲线分析[J]. 中国畜牧兽医, 2022, 49(1): 361-367.

LU Liye, NIU Fugui, WANG Zhonghua, LIN Xueyan, WANG Yun, HOU Qiuling. Receiver Operating Characteristic Curve Analysis of Biomarkers of Fatty Liver in Perinatal Dairy Cows[J]. China Animal Husbandry and Veterinary Medicine, 2022, 49(1): 361-367.

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