甘油三酯/葡萄糖指数预测非酒精性脂肪性肝病严重程度效能研究  

Efficacy of triglyceride glucose index in predicting severity of patients with non-alcoholic fatty liver diseases

作　　者：卢蓉 李慧[1] 张超[1] 邵正健 罗大光 Lu Rong;Li Hui;Zhang Chao(Health Management Center,Hunan Provincial People's Hospital,The First-Affiliated Hospital of Hunan Normal University,Changsha 410000,Hunan Province,China)

机构地区：[1]湖南师范大学附属第一医院/湖南省人民医院健康管理中心,长沙市410000

出　　处：《实用肝脏病杂志》2023年第6期805-810,共6页Journal of Practical Hepatology

基　　金：湖南师范大学医学-人文交叉学科研究基金资助项目(编号:2020-04)。

摘　　要：目的探讨应用甘油三酯-葡萄糖指数(TyG指数)预测非酒精性脂肪性肝病(NAFLD)的效能,为NAFLD的防治提供简便的筛选方法。方法2020年1月~2022月12月湖南省人民医院健康管理中心参加体检且符合纳入和排除标准的体检者44913例,使用腹部超声检查诊断NAFLD。根据文献报道的公式计算TyG指数,采用单因素和多因素Logistic回归分析影响NAFLD发生的因素,绘制TyG指数、TyG指数联合BMI和ALT预测NAFLD的受试者工作特征曲线(ROC),计算ROC曲线下面积(AUC),评估指标的预测效能。结果在纳入的44913例体检人群中,检出NAFLD患者15901例(35.4%);NAFLD组年龄、BMI、收缩压、舒张压、血清甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、空腹血糖(FPG)、ALT和TyG指数分别为(45.9±13.6)岁、(26.5±3.0)kg/m^(2)、(129.9±15.9)mm Hg、(78.7±11.2)mm Hg、(2.5±2.4)mmol/L、(3.2±0.9)mmol/L、(5.2±1.0)mmol/L、(5.7±1.6)mmol/L、(38.6±36.1)U/L和(9.1±0.7),均显著高于非NAFLD组【分别为(40.9±13.8)岁、(22.3±2.7)kg/m^(2)、(119.0±15.9)mm Hg、(70.7±10.4)mm Hg、(1.3±1.0)mmol/L、(3.0±0.8)mmol/L、(4.9±0.9)mmol/L、(5.2±0.9)mmol/L、(21.0±19.4)U/L和(8.4±0.5),P<0.001】,而NAFLD组血清高密度脂蛋白胆固醇(HDL-C)水平为(1.1±0.2)mmol/L,显著低于非NAFLD组【(1.3±1.0)mmol/L,P<0.001】;在NAFLD患者中,肥胖组收缩压、舒张压、TG、ALT和TyG指数分别为(133.3±15.3)mm Hg、(82.0±11.3)mm Hg、(2.7±2.5)mmol/L、(46.2±31.5)U/L和(9.2±0.7),均显著高于超重组【分别为(129.5±15.7)mm Hg、(78.2±10.9)mm Hg、(2.5±2.4)mmol/L、(37.7±41.0)U/L和(9.1±0.6),P<0.05】或正常组【分别为(125.9±16.4)mm Hg、(74.9±10.7)mm Hg、(2.2±2.3)mmol/L、(30.0±22.2)U/L和(9.0±0.6),P<0.05】,肥胖组年龄和血清HDL-C水平分别为(42.9±12.8)岁和(1.0±0.2)mmol/L,均显著低于超重组【分别为(46.6±13.6)岁和(1.1±0.2)mmol/L,P<0.05】或正常组【分别为(48.3±13.9)岁和(1.2±0.3)mmol/L,P<0.05】,而�Objective The aim of this study was to investigate the efficacy of triglyceride glucose index(TyG)in predicting severity of patients with non-alcoholic fatty liver diseases(NAFLD).Methods 44913 individuals who participated in health examinations at the Health Management Center,Hunan Provincial People's Hospital between January 2020 and December 2022 were enrolled.The diagnosis of NAFLD was made by ultrasonography,and the TyG index was calculated according to literature report.The univariate and multivariate Logistic regression analysis were applied to reveal the risk factors,and the area under receiver operating characteristic curve(AUC)was used to predict the diagnostic efficacy.Results Out of our 44913 participants,there were 15901 patients(35.4%)with NAFLD confirmed;the age,BMI,systolic blood pressure,diastolic blood pressure,serum triglyceride(TG),low density cholesterol(LDL-C),total cholesterol(TC),fasting plasma glucose(FPG),ALT levels and TyG index in patients with NAFLD were(45.9±13.6)years old,(26.5±3.0)kg/m^(2),(129.9±15.9)mm Hg,(78.7±11.2)mm Hg,(2.5±2.4)mmol/L,(3.2±0.9)mmol/L,(5.2±1.0)mmol/L,(5.7±1.6)mmol/L,(38.6±36.1)U/L and(9.1±0.7),all significantly higher than[(40.9±13.8)years old,(22.3±2.7)kg/m^(2),(119.0±15.9)mm Hg,(70.7±10.4)mm Hg,(1.3±1.0)mmol/L,(3.0±0.8)mmol/L,(4.9±0.9)mmol/L,(5.2±0.9)mmol/L,(21.0±19.4)U/L and(8.4±0.5),respectively,P<0.001],while serum high density cholesterol(HDL-C)levels was(1.1±0.2)mmol/L,significantly lower than[(1.3±1.0)mmol/L,P<0.001]in individuals without NAFLD;in patients with NAFLD,the systolic blood pressure,diastolic blood pressure,TG,ALT and TyG index in obese group were(133.3±15.3)mm Hg,(82.0±11.3)mm Hg,(2.7±2.5)mmol/L,(46.2±31.5)U/L and(9.2±0.7),all significantly higher than[(129.5±15.7)mm Hg,(78.2±10.9)mm Hg,(2.5±2.4)mmol/L,(37.7±41.0)U/L and(9.1±0.6),P<0.05]in overweight group and[(125.9±16.4)mm Hg,(74.9±10.7)mm Hg,(2.2±2.3)mmol/L,(30.0±22.2)U/L and(9.0±0.6),P<0.05]in normal body weight group;the age and serum HDL-C level in

关 键 词：非酒精性脂肪性肝病 甘油三酯-葡萄糖指数 LOGISTIC回归分析 受试者工作特征曲线 效能 

分 类 号：R575.5[医药卫生—消化系统]