摘要
目的探讨多囊卵巢综合征(PCOS)患者甘油三酯葡萄糖乘积指数(TyG)与非酒精性脂肪性肝病(NAFLD)患病风险的关系。方法选择上海交通大学医学院附属仁济医院内分泌科于2017年1月至2020年12月就诊的350例PCOS患者,根据其是否患NAFLD分为NAFLD组(201例)和非NAFLD组(149例)。采集患者各项临床指标,计算TyG、脂质蓄积指数(LAP)、内脏脂肪指数(VAI)。采用Spearman相关系数分析TyG与肝功能、糖脂代谢及生殖方面指标的相关性。采用logistic单因素及多因素分析TyG、LAP及VAI与PCOS患者发生NAFLD的相关性。结果两组各项临床指标及TyG、LAP、VAI比较,差异有统计学意义(P<0.05)。相关性分析显示,TyG与谷丙转氨酶、谷草转氨酶、γ-谷氨酰转肽酶、总胆固醇、低密度脂蛋白胆固醇、胰岛素曲线下面积、游离睾酮指数呈正相关(rs>0,P<0.05),与高密度脂蛋白胆固醇、性激素结合球蛋白、抗米勒管激素呈负相关(rs<0,P<0.05)。单因素logistic回归分析结果显示,年龄、体重指数、胰岛素抵抗指数、游离睾酮指数、谷丙转氨酶、TyG、LAP和VAI均为PCOS患者发生NAFLD的危险因素(OR>1,P<0.05)。为比较TyG、LAP和VAI与PCOS患者发生NAFLD的关系,避免各指数之间的相互影响,将其分别按四分位数分层,将研究对象分别纳入各指数的4个亚组,并进行多因素logistic回归,校正混杂因素,结果显示TyG>7.95、LAP>15.85、VAI>1.91均为PCOS患者发生NAFLD的独立危险因素(OR>1,P<0.05)。结论TyG指数对PCOS患者的NAFLD辅助诊断具有一定价值。
Objective To investigate the relationship between triglyceride-glucose index(TyG)and the risk of non-alcoholic fatty liver disease(NAFLD)in patients with polycystic ovary syndrome(PCOS).Methods A total of 350 PCOS patients admitted to the Department of Endocrinology and Metabolism,Renji Hospital,Shanghai Jiao Tong University School of Medicine from January 2017 to December 2020 were selected.According to whether they had NAFLD or not,they were divided into NAFLD group(201 cases)and non-NAFLD group(149 cases).TyG,lipid accumulation index(LAP)and visceral adiposity index(VAI)were calculated.Spearman correlation coefficient was used to analyze the correlation between TyG and liver function,glucolipid metabolism and reproductive indexes.Logistic univariate and multivariate analysis was used to analyze the correlation between TyG,LAP,VAI,and NAFLD in PCOS patients.Results There were statistically significant differences in clinical indicators,TyG,LAP,and VAI between the two groups(P<0.05).Correlation analysis showed that TyG was positively correlated with glutamic-pyruvic transaminase,glutamic-oxalacetic transaminase,γ-glutamyl transpeptidase,total cholesterol,low density lipoprotein cholesterol,area under insulin curve and free androgen index(rs>0,P<0.05).And it was negatively correlated with high density lipoprotein cholesterol,sex hormone-binding globulin,and anti-Müllerian hormone(rs<0,P<0.05).Univariate logistic regression analysis showed that age,body mass index,homeostasis model assessment-IR,free androgen index,glutamic-pyruvic transaminase,TyG,LAP,and VAI were all risk factors for NAFLD in PCOS patients(OR>1,P<0.05).In order to compare the relationship between TyG,LAP,VAI,and NAFLD in PCOS patients and avoid the interaction between the indexes,they were stratified by quartile,and the subjects were included in four subgroups of every index,respectively.Multivariate logistic regression was performed to correct confounding factors.The results showed that TyG>7.95,LAP>15.85,and VAI>1.91 were independent risk fa
作者
傅佳蓉
朱雨宸
虞洁
刘伟
陶弢
FU Jiarong;ZHU Yuchen;YU Jie;LIU Wei;TAO Tao(Department of Endocrinology and Metabolism,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200127,China)
出处
《中国医药导报》
CAS
2021年第28期98-102,共5页
China Medical Herald
基金
国家自然科学基金资助项目(81200628)
上海市自然科学基金项目(12ZR1417800)
上海市科学技术委员会基金项目(18411968700)。
