肥胖相关指标对非酒精脂肪肝诊断效能的研究  

The diagnostic values of obesity-related indices in nonalcoholic fatty liver disease

作　　者：黄梦 秦迁[1] 闫肃 陈静锋 丁素英[1] HUANG Meng;QIN Qian;YAN Su;CHEN Jing-feng;DING Su-ying(Health Management Center,The First Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan450052 China;不详)

机构地区：[1]郑州大学第一附属医院健康管理中心,河南郑州450052 [2]郑州大学公共卫生学院流行病与卫生统计学教研室

出　　处：《中国预防医学杂志》2022年第4期255-259,共5页Chinese Preventive Medicine

基　　金：国家自然科学基金项目(72101236);河南省重点研发与推广专项(科技攻关)支持项目(222102310226);河南省高等学校重点科研项目计划(21A320035);河南省医学科技攻关计划联合共建项目(LHGJ20200279,LHGJ20200311,LHGJ20210354);河南省青年人才托举工程项目(2021HYTP052)。

摘　　要：目的探讨肥胖相关指标对非酒精脂肪肝(nonalcoholic fatty liver disease,NAFLD)诊断效能的评价。方法选取2017年1月—2019年12月在郑州大学第一附属医院健康管理中心7000例的体检人群作为研究对象。收集受检者的问卷信息、身高、体质量、腰围、臀围、血压、人体成分等生理指标和生化及腹部彩超的资料,依据问卷信息及检查结果将受检者分为NAFLD组与对照组两组,采用t检验分析这两组之间生化指标的差异。运用logistic回归分析确定影响NAFLD的危险因素并建立NAFLD的列线图模型,然后采用Bootstrap抽样进行内部验证,应用ROC曲线评估构建的模型对于NAFLD的诊断效能。结果NAFLD的患病率为39.30%,发病年龄为(39.74±9.82)岁。根据NAFLD组和对照组两组比较显示,NAFLD组中的HDL-C低于对照组,其余指标均高于对照组,差异均有统计学意义(P均<0.05)。影响NAFLD发病的logisitci回归分析显示,模型3具有较高的诊断效能,AUC=0.87,P<0.01,敏感度0.83,特异度0.75。结论联合性别、年龄、腰围、体质量指数(body mass index,BMI)指标对NAFLD的诊断效能最优,可以作为健康人群对NAFLD的自我监测和临床早期干预的有效工具。Objective To explore the diagnostic values of obesity-related indices in nonalcoholic fatty liver disease(NAFLD).Methods A total of 7000 individuals who underwent physical examination in the health management center of the First Hospital Affiliated to Zhengzhou University from January 2017 to December 2019 were recruited in the study.The basic information of subjects were obtained via questionnaire survey,and body weight,height,waist circumference,blood pressure and body composition were measured,abdominal color ultrasound examinations were also performed.Participants were divided into NAFLD group and non-NAFLD group according to the questionnaire information and test results.The differences in the biochemical markers between the two groups were compared using t test and analysis of variance.Logistic regression analysis was used to determine the risk factors of NAFLD,and to establish the nomogram model of NAFLD.Bootstrap sampling was applied for internal validation,and ROC curve was used to evaluate the diagnostic efficiency of the model for NAFLD.Results The prevalence of NAFLD was 39.30%,and the average NAFLD onset age was(39.74±9.82)years.The HDL-C level was lower in NAFLD group compared to that in non-NAFLD group,while all other indices were significantly higher(P<0.05).The analysis of Cox proportional hazards model affecting the incidence of NAFLD showed that the model 3 had the highest diagnostic efficacy(AUC=0.87,P<0.01,sensitivity=0.83,specificity=0.75).Conclusion A model combining gender,age,waist circumference and BMI can better help in the diagnosis of NAFLD.It can be used as an effective tool for self-monitoring and early clinical intervention of healthy individuals..Conclusions The combination of gender,age,waist circumference and BMI are the best in the diagnosis of NAFLD.It can be used as an effective tool for self-monitoring and early clinical intervention of healthy people.

关 键 词：非酒精性脂肪肝 身体质量指数 内脏肥胖 诊断效能 

分 类 号：R575.5[医药卫生—消化系统]