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夏君香, 赵艳华, 何訸, 等. TG/HDL-C联合肝功指标预测代谢相关脂肪性肝病的价值[J]. 四川大学学报(医学版), 2022, 53(5): 764-769. DOI: 10.12182/20220960102
引用本文: 夏君香, 赵艳华, 何訸, 等. TG/HDL-C联合肝功指标预测代谢相关脂肪性肝病的价值[J]. 四川大学学报(医学版), 2022, 53(5): 764-769. DOI: 10.12182/20220960102
XIA Jun-xiang, ZHAO Yan-hua, HE He, et al. Application of TG/HDL-C Combined with Liver Function Indexes to Predict Metabolic-Associated Fatty Liver Disease[J]. Journal of Sichuan University (Medical Sciences), 2022, 53(5): 764-769. DOI: 10.12182/20220960102
Citation: XIA Jun-xiang, ZHAO Yan-hua, HE He, et al. Application of TG/HDL-C Combined with Liver Function Indexes to Predict Metabolic-Associated Fatty Liver Disease[J]. Journal of Sichuan University (Medical Sciences), 2022, 53(5): 764-769. DOI: 10.12182/20220960102

TG/HDL-C联合肝功指标预测代谢相关脂肪性肝病的价值

Application of TG/HDL-C Combined with Liver Function Indexes to Predict Metabolic-Associated Fatty Liver Disease

  • 摘要:
      目的  研究三酰甘油与高密度脂蛋白胆固醇比值(triglycerides to high-density lipoprotein cholesterol ratio, TG/HDL-C)联合肝功指标预测代谢相关脂肪性肝病(metabolic-associated fatty liver disease, MAFLD)的价值。
      方法  纳入明确诊断为MAFLD的门诊患者2971例,健康对照人群2794例,并收集相关数据。采用两样本Mann-Whitney U检验和二元logistic回归分析,研究TG/HDL-C与MAFLD的关系及构建MAFLD联合诊断模型,使用受试者工作特征(ROC)曲线筛选最优模型。
      结果  MAFLD患者的TG/HDL-C明显高于健康人群。在多因素分析中,调整体质量指数、收缩压、舒张压、空腹血糖、三酰甘油、高密度脂蛋白胆固醇、尿酸和肌酐后,TG/HDL-C的OR值为2.356(95%置信区间:1.028~5.400),TG/HDL-C是MAFLD的独立危险因素。进行ROC曲线分析,TG/HDL-C预测MAFLD的曲线下面积(area under the curve, AUC)为0.795(95%置信区间:0.784~0.807),cut-off值为1.09时,敏感性为0.679,特异性为0.755。由TG/HDL-C联合丙氨酸氨基转移酶、天门冬氨酸氨基转移酶和白蛋白建立的诊断模型的AUC为0.890(95%置信区间:0.882~0.898),cut-off值为0.47时,敏感性为0.792,特异性为0.839。
      结论  TG/HDL-C是MAFLD的独立危险因素,当其联合丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、白蛋白时,可较好地预测MAFLD。

     

    Abstract:
      Objective   To study the application of triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) combined with liver function indexes to predict metabolic-associated fatty liver disease (MAFLD).
      Methods  A total of 2971 outpatients diagnosed with MAFLD and 2794 healthy controls were enrolled, and their relevant data were collected. Two-sample Mann-Whitney U test and binary logistic regression analysis were conducted to study the relationship between TG/HDL-C and MAFLD and to construct combined diagnosis models of MAFLD. The area under the curve (AUC) of receiver operating characteristic (ROC) was used to pick out the optimal model.
      Results  The TG/HDL-C of MAFLD patients was significantly higher than that of healthy controls. In multivariate analysis, after adjusting for body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, uric acid and creatinine, the odds ratio of TG/HDL-C was 2.356 (95% confidence interval CI: 1.028-5.400). Therefore, TG/HDL-C was an independent risk factor for MAFLD. ROC curve analysis showed that the AUC of using TG/HDL-C to predict MAFLD was 0.795 (95% CI: 0.784-0.807), and when the cut-off value was 1.09, the sensitivity was 0.679 and the specificity was 0.755. The AUC of the diagnosis model established by a combined use of TG/HDL-C, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) was 0.890 (95% CI: 0.882-0.898), and when the cut-off value was 0.47, the sensitivity and specificity were 0.792 and 0.839, respectively.
      Conclusion  TG/HDL-C is an independent risk factor for MAFLD. TG/HDL-C can well predict MAFLD when it is used in combination with ALT, AST, and ALB.

     

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