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

作　　者：夏君香 赵艳华[1] 何訸[1] 梁珊珊 干伟[1] 李贵星[1] XIA Jun-xiang;ZHAO Yan-hua;HE He;LIANG Shan-shan;GAN Wei;LI Gui-xing(Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院实验医学科,成都610041

出　　处：《四川大学学报（医学版）》2022年第5期764-769,共6页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技计划项目(No.2021YFS0148)资助。

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2 971例,健康对照人群2 794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。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 2 971 outpatients diagnosed with MAFLD and 2 794 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 cutoff 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.

关 键 词：代谢相关脂肪性肝病 TG/HDL-C 诊断模型 

分 类 号：R575[医药卫生—消化系统]