دور الجليبكان4- والبنتراكسين3- ومؤشر الدهون السكرية كمؤشرات محتملة في تقييم مرضى الكبد الدهني غير الكحولي.

The Role of Serum Glypican-4 ,Pentraxin-3 and Triglyceride –Glucose index as potential marker in assessments of Non Alcoholic Fatty Liver patient

In Western society, fatty liver disease is the most prevalent chronic liver condition. It is brought on by the build-up of fatty acids in liver parenchymal cells as triglycerides rather than by alcohol or the hepatitis virus. One of the most prevalent causes of liver illnesses is non-alcoholic fatty liver disease (NAFLD), and its incidence is rising globally, Non- alcoholic fatty liver disease (NAFLD) involves a spectrum of liver diseases ranging from steatosis, non-alcoholic steatohepatitis(NASH),and fibrosis to cirrhosis. NAFLD is a multisystem disease with extra hepatic disease implications that include type 2 diabetes and cardiovascular disease (CVD). Non-alcoholic fatty liver disease is now known as metabolic dysfunction associated fatty liver disease (MAFLD).
This study aimed to determine the role of Glypican-4, pentraxin-3 Triglyceride –Glucose index a new marker in patient with fatty liver disease, Nonalcoholic fatty liver disease(NAFLD) and Non-alcoholic steatohepatitis(NASH),cirrhosis and in control volunteer ,evaluate the level of lipid profile , insulin resistance and alanine transaminase (ALT),aspartate aminotransferase (AST)in people with and without fatty liver disease. The current study was conducted on ninety patients suffering from fatty liver and thirty healthy. Group1 (30)patient of NAFLD , group2 (30) patient NASH , group3 (30) patient cirrhosis and group 4 (30) healthy as a control. During the period extending between November 2023 to April 2024, Collection of samples carried out from Babylon gastroenterology α hepatology center . The patients’ socio demographic data, including their ages, genders, weights, heights .

The human pentraxin-3 (PTX3) serum level and glypican-4 (GPC4) were measured by using the ELISA system, while TyG index was calculated as ln (fasting triglyceride/fasting glucose/2) were measured by DIRUI CS-T180 auto chemistry analyzer ,and other parameter lipid profile (cholesterol and high density lipoprotein(HDL)) and liver enzyme (AST,ALT) were measured by DIRUI CS-T180 auto chemistry analyser.
The result of this study, the age differences between group1(NAFLD), group2 (NASH), group3(Cirrhosis) , and control were statistically significant (p≤0.05). After comparing the three groups (G1, G2, and G3) to the control, it was discovered that the group 3had a higher mean than the control group. The three groups of body mass index (BMI)(group1,group2, and group3) were determined to be more valuable than the control group, although the highest value was group 1. The BMI differences between the groups are significant.
In TYG and GLY-4, but not in PEN-3, there was a statistically significant difference (p≤0.05) between the patient groups and the control group. The means of TYG for groups 1 (NAFLD),2(NASH), and 3 (cirrhosis) were higher than the control group but remained quite similar. In GLY-4, the group means (group 1, group 2, group 3) are higher than the control group , with group 3 having the highest mean overall . Group 1 mean was greater than group 2, and group 3 mean was higher than those of the other groups and the control group in PEN-3.
There was a strong positive correlation ( p<0.01) observed in regard to ALT with both BMI and AST. Additionally, there was a significant positive correlation (p<0.01) discovered between LDL and BMI. HDL shows a strong positive correlation with age and a strong negative correlation with BMI, in

contrast to LDL. Triglycerides show a strong positive correlation (P<0.01) with ALT and LDL and a negative correlation (P≤0.05) with HDL.
Cholesterol has a negative correlation with HDL and a positive correlation with triglycerides and LDL. It also has a positive correlation (P<0.01)with ALT and BMI. VLDL and LDL, TG, and cholesterol have a strong positive association. And unfavorable association with HDL.
Age and glucose are positively correlated, there is a positive correlation (p<0.01)between HOMA-IR and glucose.
The statistical analysis revealed a substantial positive correlation (p<0.01)between marker PEN-3 and GLY-4. Age, LDL, triglycerides, cholesterol, glucose, and HOMA-IR were found to have a significant positive connection (p<0.01), according to TYG.