摘要
目的探讨脂质蓄积指数(LAP)和内脏脂肪指数(VAI)与非酒精性脂肪性肝病(NAFLD)的相关性,并评估其对NAFLD患病风险的预测价值。方法随机纳入2018年9月—2019年5月北京中日友好医院的708例体检受试者,分为NAFLD组(n=426)和非NAFLD组(n=282),比较两组间LAP、VAI及相关生化指标差异。计量资料符合正态分布的2组间比较采用t检验,不符合正态分布者2组间比较采用Mann-Whitney U秩和检验。计数资料2组间比较采用χ^(2)检验。应用Spearman进行相关性分析。然后将LAP、VAI根据四分位数水平分为四组(L1~L4;V1~V4),比较各组间NAFLD的分布情况,采用logistic回归分析计算不同LAP、VAI水平NAFLD的发生风险,绘制不同性别和体质量亚组LAP、VAI、腰围(WC)、体质量指数(BMI)预测NAFLD的ROC曲线,以评估各指标对NAFLD的预测诊断价值。结果NAFLD组受试者的年龄、男性、吸烟史占比以及LAP、VAI、WC、BMI、收缩压(SBP)、舒张压(DBP)、ALT、AST、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、血尿酸(SUA)水平均显著高于非NAFLD组,而高密度脂蛋白胆固醇(HDL-C)水平显著低于非NAFLD组(P值均<0.01)。NAFLD与LAP、VAI水平呈正相关(Cramer’s V值分别为0.552、0.464)。多因素logistic回归显示,在调整各危险因素后,L4组NAFLD发生风险仍为L1组的8.811(95%CI:4.335~17.910)倍(P<0.001),V4组NAFLD发生风险仍为V1组的5.967(95%CI:3.263~10.912)倍(P<0.001)。ROC曲线结果显示,不同性别和体质量亚组中LAP、VAI预测NAFLD发生的AUC均>0.7。其中,女性亚组LAP、VAI预测NAFLD的AUC显著高于男性亚组(0.886 vs 0.785,0.824 vs 0.748,P值均<0.05),且对应的灵敏度(79.8%vs 63.7%,77.9%vs 77.0%)、特异度(85.0%vs 81.1%,77.6%vs 62.3%)也偏高。结论NAFLD患病风险随着LAP、VAI水平增高而升高;LAP、VAI对不同性别和体质量亚组的NAFLD的发生均有良好预测价值,且对女性NAFLD的预测能力更佳。
Objective To investigate the association of lipid accumulation product(LAP)and visceral fat index(VAI)with nonalcoholic fatty liver disease(NAFLD)and the value of LAP and VAI in predicting the risk of NAFLD.Methods A total of 708 subjects who underwent physical examination in China-Japan Friendship Hospital from September 2018 to May 2019 were enrolled and divided into NAFLD group(n=426)and non-NAFLD group(n=282),and the two groups were compared in terms of LAP,VAI,and related biochemical parameters.The independent samples t-test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups.The chi-square test was used for comparison of categorical data between groups.The Spearman test was used for correlation analysis.The subjects were divided into L1-L4 groups based on LAP and V1-V4 groups based on VAI,and the distribution of NAFLD was compared between groups;a logistic regression analysis was used to calculate the risk of NAFLD at different levels of LAP and VAI,and the receiver operating characteristic(ROC)curves were plotted for LAP,VAI,waist circumference(WC),and body mass index(BMI)in predicting NAFLD in different sex and body weight subgroups,so as to evaluate the value of each index in the prediction and diagnosis of NAFLD.Results Compared with the non-NAFLD group,the NAFLD group had significantly higher age,proportion of male subjects,proportion of subjects with a smoking history,and levels of LAP,VAI,WC,BMI,systolic blood pressure,diastolic blood pressure,alanine aminotransferase,aspartate aminotransferase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,fasting blood glucose,and serum uric acid,as well as a significantly lower level of high-density lipoprotein cholesterol(all P<0.01).NAFLD was positively correlated with the levels of LAP and VAI(Cramer’s V=0.552 and 0.464).The multivariate logistic regression analysis showed that after adjustment for relat
作者
段绍杰
刘尊敬
陈佳良
姚树坤
DUAN Shaojie;LIU Zunjing;CHEN Jialiang;YAO Shukun(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Department of Neurology,China-Japan Friendship Hospital,Beijing 100029,China;Department of Gastroenterology,China-Japan Friendship Hospital,Beijing 100029,China;Center of Integrative Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2022年第1期129-134,共6页
Journal of Clinical Hepatology
关键词
非酒精性脂肪性肝病
脂质蓄积指数
内脏脂肪指数
诊断
Non-alcoholic Fatty Liver Disease
Lipid Accumulation Index
Visceral Fat Index
Diagnosis
