title: A case-control study: Association between serum neuregulin 4 level and non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is a great health burden. Neuregulin 4 (Nrg4) is a recently identified secret factor that may be associated with NAFLD.
  
  
  OBJECTIVE
  To investigate the association between serum Nrg4 level and NAFLD by conducting a case-control study.
  
  
  METHODS
  A total of 174 subjects were included. 87 NAFLD subjects and 87 age- and sex-matched non-NAFLD controls were identified by hepatic ultrasound examination. Anthropometric and biochemical data were measured and recorded. Serum Nrg4 level was evaluated by using enzyme-linked immunosorbent assay. SPSS software was used for statistical analyses.
  
  
  RESULTS
  Compared to the controls, subjects with NAFLD presented with reduced level of serum Nrg4 (0.40 (0.27, 0.55) vs. 0.50 (0.30, 0.81)ng/mL (median (interquartile range)), P=0.029). By multivariate logistic regression analysis, reduced serum levels of Nrg4 were associated with higher NAFLD odds (OR=0.251, 95% confidence interval=0.081-0.779, P=0.017). By dividing the distribution of serum Nrg4 level into quartiles, there was borderline statistical difference of NAFLD prevalence among the four groups (P=0.058). There was no significant difference of serum Nrg4 levels in subjects according to the grades of fatty liver by ultrasound (P=0.080). No statistical difference of serum Nrg4 level was observed between obese and non-obese subjects (P=0.932).
  
  
  CONCLUSIONS
  Decreased serum Nrg4 level is prevalent in NAFLD subjects compared to non-NAFLD controls, and is an independent risk factor associated with NAFLD, indicating that Nrg4 might have a protective role in the development of NAFLD.
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Yi-Ning
authors.initials: YN
authors.lastname: Dai
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Jin-Zhou
authors.initials: JZ
authors.lastname: Zhu
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Zhi-Yun
authors.initials: ZY
authors.lastname: Fang
authors.affiliation: Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: De-Jian
authors.initials: DJ
authors.lastname: Zhao
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Xing-Yong
authors.initials: XY
authors.lastname: Wan
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Hua-Tuo
authors.initials: HT
authors.lastname: Zhu
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China. Electronic address: zlym@zju.edu.cn.
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Li
mesh_terms: D002001:Adipose Tissue, Brown / Q000378:metabolism; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020880:Neuregulins / Q000097:blood* / Q000502:physiology; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000209:etiology; D009765:Obesity / Q000097:blood
chemical_list: D001786:Blood Glucose; D020880:Neuregulins; C467747:neuregulin-4
keywords: Neuregulin 4; Non-alcoholic fatty liver disease; Obesity