肝脂肪变性相关指数对2型糖尿病患者合并非酒精性脂肪性肝病的预测价值  

Predictive value of hepatic steatosis related indexes in type 2 diabetes patients with non-alcoholic fatty liver disease

作　　者：田昊文 邓霞[1] 杨玲[1] TIAN Haowen;DENG Xia;YANG Ling(Department of Endocrinology and Metabolism,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院内分泌科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2023年第6期521-527,共7页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)人群中肝脂肪变性相关指数与非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的关系。方法:共纳入566例T2DM受试者,收集临床资料,根据超声检查结果分为无NAFLD组与NAFLD组。比较两组受试者一般临床资料以及肝脏脂肪变性指数(hepatic steatosis index,HSI)和脂肪肝指数(fatty liver index,FLI)。Logistic回归分析以探讨HSI和FLI与T2DM患者发生NAFLD的关系。应用受试者工作特性(ROC)曲线评估HSI和FLI的诊断价值。结果:NAFLD组的HSI(40.66±5.60 vs 34.58±3.99)和FLI(58.86±21.21 vs 28.96±20.18)明显高于无NAFLD组(P<0.001)。相关分析显示,HSI、FLI与稳态模型评估胰岛素抵抗指数(HOMA-IR)、腰围、三酰甘油和总胆固醇呈正相关,但与高密度脂蛋白胆固醇(HDL-C)呈负相关。Logistic回归分析显示,在控制代谢危险因素和降糖药物后,HSI和FLI仍然是T2DM患者发生NAFLD的独立危险因素。HSI诊断T2DM合并NAFLD的敏感性为82.5%,特异性为68.6%;FLI诊断T2DM合并NAFLD的敏感性为86.0%,特异度为70.5%。结论:HSI和FLI根据患者的常规生化指标计算而得,简单方便,对T2DM患者发生NAFLD具有良好的预测价值。Objective:To explore the correlation between hepatic steatosis index(HSI),fatty liver index(FLI)and nonalcoholic fatty liver disease(NAFLD)in type 2 diabetes mellitus(T2DM)population.Methods:A total of 566 subjects with T2DM were included.Clinical data were collected,and they were divided into non-NAFLD group and NAFLD group according to ultrasonography results.General clinical data,HSI and FLI were compared between the two groups.Logistic regression analysis was performed to explore the correlation between HSI,FLI and NAFLD in T2DM patients.The diagnostic value of HSI and FLI were evaluated according to receiver operating characteristic(ROC)curve.Results:The HSI(40.66±5.60 vs 34.58±3.99)and FLI(58.86±21.21 vs 28.96±20.18)in NAFLD group were significantly higher than those in non-NAFLD group(P<0.001).Correlation analysis showed that HSI and FLI were positively correlated with HOMA-IR,waist circumference,triglyceride and total cholesterol,but it was negatively correlated with high density lipoprotein cholesterol(HDL-C).Logistic regression analysis showed that after controlling for metabolic risk factors and hypoglycemic agents,HSI and FLI remained independent risk factors for NAFLD in T2DM patients.The sensitivity and specificity of HSI in diagnosing T2DM with NAFLD were 82.5%and 68.6%respectively.The sensitivity and specificity of FLI in diagnosing T2DM with NAFLD were 86.0%and 70.5%respectively.Conclusion:The HSI and FLI of T2DM patients are calculated according to the conventional biochemical indicators,which is simple and convenient,and may be used to diagnose NAFLD.

关 键 词：非酒精性脂肪肝 2型糖尿病 肝脂肪变性指数 脂肪肝指数 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]