肝脏受控衰减参数检测早期无创发现代谢综合征人群价值分析  

Application of controlled attenuation parameter in screening individuals with risk of metabolic syndrome

作　　者：董雪莲[1] 张文均 Dong Xuelian;Zhang Wenjun

机构地区：[1]青海省中医院肝病科,西宁市810000 [2]湖北医药学院附属人民医院神经内科

出　　处：《实用肝脏病杂志》2018年第6期868-871,共4页Journal of Practical Hepatology

基　　金：西宁市科技局科研基金资助项目(编号:2014Y31)

摘　　要：目的探讨肝脏受控衰减参数(CAP)检测在预测代谢综合征(MetS)发生风险中的价值。方法在健康体检者中发现662例MetS患者和1577例健康人,使用法国502型FibroScan行肝硬度测量(LSM)和CAP检测。常规获得其他临床资料。结果健康人和MetS组体质指数(BMI)分别为[(22.0±2.9) kg/m^2和(25.5±1.4) kg/m^2],腰围(WC)分别为[(78.9±6.7)cm和(85.3±7.1)cm],收缩压(SBP)分别为[(128.0±17.0) mmHg和(139±16)mmHg],舒张压(DBP)分别为[(76.0±9.0) mmHg和(87.0±5.0) mmHg,均差异显著(P<0.001);健康人和MetS组空腹血糖(FPG)分别为[(5.3±0.4)mmol/L和(6.3±0.4)mmol/L],甘油三酯(TG)分别为[(1.3±0.5)mmol/L和(2.1±0.6)mmol/L],总胆固醇(TC)分别为[(4.7±0.5) mmol/L和(5.0±0.6) mmol/L],高密度脂蛋白胆固醇(HDL-C)分别为[(1.6±0.1) mmol/L和(1.3±0.2) mmol/L],低密度脂蛋白胆固醇(LDL-C)分别为[(2.1±0.3)mmol/L和(2.7±0.4)mmol/L],丙氨酸氨基转移酶(ALT)分别为[(36.5±3.1) U/L和(102.3±4.7) U/L],天冬氨酸氨基转移酶(AST)分别为[(33.4±5.8) U/L和(125.3±7.6) U/L],LSM分别为[(4.8±0.2) kPa和(6.6±0.3) kPa],CAP值分别为[(213.1±24.3) dB/m和(269.4±30.2) dB/m],均有显著性差异(P<0.001);经Logistic回归分析,发现BMI、WC、血压、空腹血糖、血脂和CAP是影响MetS发生的独立危险因素。结论 CAP检测能早期无创发现MetS人群,在大规模体检人群中值得应用。Objective To investigate the application of controlled attenuation parameter(CAP)in screening individuals with risk of metabolic syndrome(MetS).Methods 662 persons with MetS and 1577 healthy individuals were recruited,and screened by Fibroscan for liver stiffness measure(LSM)and CAP.The clinical parameters were obtained routinely.Results The body mass index(BMI)were[(22.0±2.9)kg/m2 and(25.5±1.4)kg/m2],the waist circumference(WC)were[(78.9±6.7)cm and(85.3±7.1)cm],the systolic blood pressure(SBP)were[(128.0±17.0)mmHg and(139.0±16.0)mmHg]and the diastolic blood pressure(DBP)were[(76.0±9.0)mmHg and(87.0±5.0)mmHg]in healthy persons and in patients with MetS(P<0.001);the fasting plasma glucose(FPG)levels were[(5.3±0.5)mmol/L and(6.3±0.4)mmol/L],serum triglyceride(TG)levels were[(1.3±0.5)mmol/L and(2.1±0.6)mmol/L],serum total cholesterol(TC)were[(4.7±0.5)mmol/L and(5.0±0.6)mmol/L],HDL-C were[(1.6±0.1)mmol/L and(1.3±0.2)mmol/L],LDL-C were[(2.1±0.3)mmol/L and(2.7±0.5)mmol/L],alanine aminotransferase(ALT)were[(36.5±3.1)U/L and(102.3±4.7)U/L],aspartate aminotransferase(AST)were[(33.4±5.8)U/L and(125.3±7.6)U/L],LSM were[(4.8±0.2)kPa and(6.6±0.3)kPa]and CAP were[(213.1±24.3)dB/m and(269.4±30.2)dB/m]in the two groups(P<0.001);Logistic analysis showed that BMI,WC,blood pressure,FPG,serum lipid and CAP were the independent risk factors for the development of MetS.Conclusions The screening of individuals with MetS by CAP measure is practical and noninvasive,which warrants further investigation.

关 键 词：非酒精性脂肪性肝病 代谢综合征 受控衰减参数 筛查 

分 类 号：R575.5[医药卫生—消化系统]