甘油三酯葡萄糖指数与非酒精性脂肪性肝病脂肪变程度及肝纤维化的相关性研究  

Correlation between the triglyceride glucose index and the degree of steatosis and liver fibrosis in nonalcoholic fatty liver disease

作　　者：努尔吉马·阿合尼牙孜 刘一佳 梁灿灿[1] 丁永年[1] NUERJIMA Aheniyazi;LIU Yi-jia;LIANG Can-can;DING Yong-nian(Department of Gastroenterology,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Medical Records,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第二附属医院消化内科,新疆乌鲁木齐830000 [2]新疆医科大学第二附属医院病案室,新疆乌鲁木齐830000

出　　处：《海南医学院学报》2023年第23期1794-1800,共7页Journal of Hainan Medical University

基　　金：新疆维吾尔自治区自然科学基金(2021D01C356);省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2021-EF2)。

摘　　要：目的:探讨甘油三酯葡萄糖指数(triglyceride glucose index,TyG指数)与非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)脂肪变程度及肝纤维化之间的相关性。方法:回顾性选取2020年9月~2021年9月在新疆医科大学第二附属医院住院的2 054例患者,根据腹部彩超分为NAFLD组与非NAFLD组。将NAFLD组患者行瞬时弹性成像技术,根据脂肪变程度分为轻度组、中度组、重度组,根据肝脏硬度分为肝纤维化组、无肝纤维化组。采用Logistic回归分析TyG指数与脂肪变严重程度及肝纤维化的相关性。采用受试者工作特征曲线(ROC)评价TyG指数与NAFLD及肝纤维化的诊断价值。结果:NAFLD患病率随着TyG指数四分位数值升高而递增(Q_(1) 44.1%,Q_(2) 58.7%,Q_(3) 71.9%,Q_(4) 84.6%,P<0.001);肝纤维化患病率随着TyG指数四分位数值升高而递增(Q_(1) 25.8%,Q_(2) 30.2%,Q_(3) 38.6%,Q_(4) 44.3%,P<0.001)。校正混杂因素后,在NAFLD患者中,TyG指数与脂肪变严重程度存在相关性(轻度组、中度组、重度组对应OR值分别为1.383、2.450、3.070,P<0.001)。TyG指数与肝纤维化相关(OR=1.132,P<0.001)。TyG指数预测NAFLD的ROC曲线下面积为0.701,最佳截断值为8.57。然而,TyG指数预测肝纤维化的ROC曲线下面积为0.595。TyG指数可能不是预测肝纤维化可靠的指标。结论:TyG指数与NAFLD脂肪变严重程度及肝纤维呈正相关。Objective:To investigate the relationship between triglyceride glucose index(TyG)and the degree of steatosis and liver fibrosis in patients with nonalcoholic fatty liver disease(NAFLD).Methods:Totally 2054 patients hospitalized in the second affiliated hospital of Xinjiang Medical University from September 2020 to September 2021 were retrospectively selected According to abdominal ultrasound were divided into NAFLD group and non⁃NAFLD group.In accordance with the degree of ste⁃atosis,NAFLD patients were separated into mild group,moderate group and severe group.According to the liver stiffness,NAFLD patients were divided into liver fibrosis group and non⁃liver fibrosis group.We used the logistic regression to examine the correlation between TyG index and the the degree of steatosis and liver fibrosis.ROC curve was drawn to evaluate the diagnostic value of TyG index for NAFLD and liver fibrosis.Results:The prevalence of NAFLD increased with the increase of the interquar⁃tile of TyG index(Q_(1) 44.1%,Q_(2) 58.7%,Q_(3) 71.9%,Q_(4) 84.6%,P<0.001);The prevalence of liver fibrosis increased with the in⁃crease of the interquartile of TyG index(Q_(1) 25.8%,Q_(2) 30.2%,Q_(3) 38.6%,Q_(4) 44.3%,P<0.001).After adjusting for confounders,there was a correlation between TyG index and the degree of steatosis in NAFLD patients(the OR values of mild,moderate and severe groups were 1.383,2.450 and 3.070,P<0.001).TyG index was associated with liver fibrosis(OR=1.132,P<0.001).The ROC curve of TyG index predicted NAFLD was 0.701,with an optimal cutoff of 8.57.However,the ROC curve of TyG in⁃dex predicted liver fibrosis was 0.595.TyG index may not be a reliable predictor of liver fibrosis.Conclusion:TyG index was posi⁃tively correlated with the degree of steatosis and liver fibrosis in NAFLD.

关 键 词：甘油三酯葡萄糖指数 非酒精性脂肪性肝病 脂肪变 肝纤维化 

分 类 号：R575.5[医药卫生—消化系统]