生物电阻抗法测定体脂率、内脏脂肪面积及静息代谢率与代谢相关脂肪性肝病的关系  

Relationship between metabolic associated fatty liver disease and body fat ratio,visceral fat area,and resting metabolic rate estimated by bioelectrical impedance analysis

作　　者：贺登花 张勇湛[1] 徐亮[2] 裴佳佳 张颖 闫忠芳 Deng-Hua He;Yong-Zhan Zhang;Liang Xu;Jia-Jia Pei;Ying Zhang;Zhong-Fang Yan(Department of Clinical Nutrition,Tianjin Second People’s Hospital,Tianjin 300192,China;Department of Hepatology,Tianjin Second People’s Hospital,Tianjin 300192,China;Department of Clinical Nutrition,Tianjin An Ding Hospital,Tianjin 300222,China)

机构地区：[1]天津市第二人民医院营养科,天津市300192 [2]天津市第二人民医院肝病科,天津市300192 [3]天津市安定医院营养科,天津市300222

出　　处：《世界华人消化杂志》2023年第2期56-65,共10页World Chinese Journal of Digestology

基　　金：天津市卫生健康科技项目,No.RC-20038。

摘　　要：背景早期识别代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)的发病风险非常重要,通过安全、无创的生物电阻抗法(bioelectrical impedance analysis,BIA)测定人体成分来预测MAFLD可能是一种新途径.目的通过BIA法测定人体组成成分,探索体脂率(body fat ratio,BFR)、内脏脂肪面积(visceral fat area,VFA)及静息代谢率(resting metabolic rate,RMR)与MAFLD的关系.方法根据是否患有MAFLD将509例研究对象分为MAFLD组和非MAFLD组,收集人体测量、人体成分分析及实验室检测相关指标,利用Spearman相关分析、绘制受试者工作特征曲线(receiver operating characteristic curves,ROC)及Logistic回归分析等方法探索BFR、VFA和RMR与MAFLD及其相关指标间的关系.结果男性和女性的BFR、VFA和RMR在MAFLD组与非MAFLD的组间分布差异有统计学意义(P<0.05),且BFR、VFA和RMR与丙氨酸转氨酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBIL)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、空腹血糖(fasting bloodglucose,FBG)、餐后2小时血糖(postprandialblood glucose,PBG)等多个实验室检测指标显著相关(P<0.05);BFR、VFA和RMR预测MAFLD的ROC曲线下面积(area under the ROC curve,AUC)分别为0.800(95%CI:0.752-0.875)、0.894(95%CI:0.847-0.941)和0.715(95%CI:0.639-0.790),其中VFA为最优指标,其界值为87.10 cm^(2),男性和女性V FA预测MAFLD的AUC分别为0.943(95%CI:0.910-0.976)和0.907(95%CI:0.850-0.965),其界值分别为87.25cm^(2)和117.05cm^(2);调整性别、年龄、FBG、TG和HDL-C后做Logistic回归分析,BFR、VFA和RMR的OR值分别为1.357(95%CI:1.214-1.517)、1.079(95%CI:1.049-1.111)和1.009(95%CI:1.005-1.014).结论BIA法测定BFR、VFA和RMR可用于MAFLD的患病风险预测中,其中VFA是BIA测定法中预测MAFLD的最优指标.BACKGROUND It is very important to identify the risk of metabolic associated fatty liver disease(MAFLD)in early stage,and body components measured by bioelectrical impedance analysis(BIA)would be a new way to achieve the prediction safely and noninvasively.AIM To measure the body composition by BIA,and explore the association of body fat ratio(BFR),visceral fat area(VFA),and resting metabolic rate(RMR)with MAFLD.METHODS A total of 509 subjects were divided into either a MAFLD group or a non-MAFLD group.Indicators of anthropometric measurements,BIA,and laboratory tests were collected.Spearman correlation analysis,receiver operating characteristic(ROC)curve analysis,and binary logistic regression analysis were used to explore the relationship of BFR,VFA,and RMR with MAFLD.RESULTS The differences in BFR,VFA,and RMR between the MAFLD group and the non-MAFLD group were statistically significant both in male and female subjects(P<0.05),and BFR,VFA,and RMR were significantly correlated with alanine aminotransferase,total bilirubin,triglyceride(TG),total cholesterol,fasting blood-glucose(FBG),and postprandial blood glucose(P<0.05).The area under the ROC curve(AUC)values of BFR,VFA,and RMR were 0.800(95%confidence interval[CI]:0.752-0.875),0.894(95%CI:0.847-0.941),and 0.715(95%CI:0.639-0.790),respectively,and VFA was the best indicator with a cutoff value of 87.10 cm^(2)(87.25 cm^(2) in males and 117.05 cm^(2) in females).The odds ratio values of BFR,VFA,and RMR were 1.357(95%CI:1.214-1.517),1.079(95%CI:1.049-1.111),and 1.009(95%CI:1.005-1.014),respectively,after adjsuting for gender,age,FBG,and TG.CONCLUSION BFR,VFA,and RMR estimated by BIA method can be well applied in the risk prediction of MAFLD,with VFA being the best indicator.

关 键 词：体脂率 内脏脂肪面积 静息代谢率 代谢相关脂肪性肝病 生物电阻抗分析法 

分 类 号：R575.5[医药卫生—消化系统]