Abstract:

Objective The relationship between serum Cytokeratin⁃18（CK⁃18）and hepatic steatosis in patients with non⁃alcoholic fatty liver disease（NAFLD）was unclear. The aim of this study was to investigate the correlation of serum CK ⁃18 M30 and M65 with the hepatic steatosis in patients with magnetic resonance imaging proton density fat fraction（MRI⁃PDFF）diagnosed NAFLD，and the diagnostic value of CK⁃18 M30 and M65 on hepatic steatosis. Methods Health controls and patients with NAFLD were recruited，and the basic information and clinical parameters were collected. The concentrations of serum CK⁃18 M30 and M65 were measured with the enzyme linked immunosorbent assay（ELISA）methods. All participates were subjected to the MRI⁃PDFF examina⁃ tion and the degrees of hepatic steatosis were represented by the MRI⁃PDFF values. Patients with NAFLD were divided into the S1 group and S2 & S3 group according to the MRI⁃PDFF values. Statistical analyze were conducted by the SPSS 26.0 software. Results A total of 120 subjects were included，which comprised of 40 health controls and 80 NAFLD patients. Serum CK ⁃18 M30 levels in S2&S3 group were significant different compared to the S1 group and health controls（P = 0.037，P = 0.005），but not different between S1 group and health controls（P = 0.292）. No significant differences of serum CK⁃18 M65 levels in each group. Pearson correlation coefficient analysis suggested that serum CK⁃18 M30 levels were positively associated with hepatic steatosis（r = 0.404）. The area under the receiver operating characteristic（AUROC）values，sensitivity，specificity，and cut⁃off values of serum CK⁃18 M30 levels on diagnosing the hepatic steatosis were 0.611 and 0.666，53.75% and 60.71%，72.5% and 79.35%，100.4 U/L and 118.9 U/L，respectively. Conclusion This study found serum CK⁃18 M30 level was elevated in patients with hepatic steatosis，and was positively correlated with MRI⁃PDFF，indicating that the level of CK⁃18 M30 in NAFLD patients was associated with progress of hepatic steatosis. We did not find a correlation between serum CK⁃18 M65 levels and hepatic steatosis. The association of serum CK⁃18 M30 with the degree of hepatic steatosis deserves further study.

Key words:

non?alcoholic fatty liver disease, cytokeratin?18, magneticresonance imaging