甘油三酯葡萄糖指数联合体重指数的轨迹与新发非酒精性脂肪性肝病的相关性  

The reliation between trajectory of triglyceride glucose index combined with body mass index and new-onset non-alcoholic fatty liver disease

作　　者：秦迁[1] 张滔 闫肃 杨阳[1] 闫航[1] 丁素英[1] Qin Qian;Zhang Tao;Yan Su;Yang Yang;Yan Hang;Ding Suying(Health Management Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;People′s Hospital of Zhongjiang,Deyang 618100,China)

机构地区：[1]郑州大学第一附属医院健康管理中心,郑州450052 [2]中江县人民医院体检科,德阳618100

出　　处：《中华健康管理学杂志》2023年第12期909-915,共7页Chinese Journal of Health Management

基　　金：河南省科技攻关计划(222102310226);河南省医学科技攻关计划联合共建项目(LHGJ20210354)。

摘　　要：目的探讨甘油三酯葡萄糖指数联合体重指数(TyG×BMI)的轨迹与新发非酒精性脂肪性肝病(NAFLD)的相关性。方法本研究为回顾性队列研究,选取2017—2019连续3年于郑州大学第一附属医院健康管理中心进行体检的受检者,共2304例为研究对象。依据健康体检的TyG×BMI数值,采用潜类别模型分组确定4个不同的TyG×BMI轨迹组,分别为低稳定组、中稳定组、高稳定组、极高稳定组。于2020、2021年体检时,随访各组人群NAFLD的发病情况。用Log-rank检验比较不同TyG×BMI轨迹组NAFLD发病率的差异,采用Cox比例风险回归模型分析不同TyG×BMI轨迹与新发NAFLD的相关性。结果NAFLD的发病率随着TyG×BMI轨迹的升高而增加,低、中、高、极高稳定组人群的累积发病率分别为13.00%、16.70%、20.10%和26.60%(χ^(2)=35.155,P<0.01)。与低稳定组相比,高、极高稳定组NAFLD的发病风险更高(高稳定组HR分别为1.564、1.428、1.426、1.389,极高稳定组HR分别为2.121、1.670、1.659、1.607,均P<0.05);其中在模型4中,校正性别、腰围、BMI、血糖、血脂、肝功等多种混杂因素后,高、极高稳定组的NAFLD的患病风险仍为低稳定组的1.389和1.607倍(95%CI:1.035~1.864、1.207~2.140)。结论NAFLD的患病风险随着TyG×BMI轨迹的升高而增加,TyG×BMI可作为NAFLD的预测指标。Objective To investigate the correlation between the trajectory of triglyceride-glucose index multiplied by body mass index(TyG×BMI)and the incidence of new-onset non-alcoholic fatty liver disease(NAFLD).Methods It was a retrospective cohort study.A total of 2304 subjects who underwent health examinations at the Health Management Center of the First Affiliated Hospital of Zhengzhou University from 2017 to 2019 were included as the study population.Based on the TyG×BMI values from the health examinations,a latent class modeling approach was used to determine four distinct TyG×BMI trajectory groups:low-stable,moderate-stable,high-stable,and extremely high-stable group.The incidence of NAFLD was followed-up during the 2020 and 2021 health examinations for each group.The differences in NAFLD incidence among different TyG×BMI trajectory groups were compared using the log-rank test,and the correlation between different TyG×BMI trajectories and the incidence of new-onset NAFLD was analyzed using Cox proportional hazards regression models.Results The incidence of NAFLD increased with the elevation of TyG×BMI trajectories.The cumulative incidence rates of NAFLD for the low-stable,moderate-stable,high-stable,and extremely high-stable groups was 13.00%,16.70%,20.10%and 26.60%,respectively,with statistically significant differences(χ^(2)=35.155,P<0.01).Compared with the low-stable group,the high-stable and extremely high-stable groups had higher risks of NAFLD(HRs for high-stable group was 1.564,1.428,1.426,1.289,respectively;HRs for extremely high-stable group was 2.121,1.670,1.659,1.607,respectively;all P<0.05).After adjusting for various confounding factors such as gender,waist circumference,BMI,blood glucose,blood lipids and liver function in model 4,the risks of NAFLD for the high-stable and extremely high-stable groups were still 1.389 and 1.607 times higher than that in the low-stable group(95%CIs:1.035-1.864,1.207-2.140).Conclusion The risk of NAFLD increases with the elevation of TyG×BMI trajectories,suggest

关 键 词：脂肪肝 非酒精性脂肪性肝病 轨迹研究 队列研究 相关性 

分 类 号：R575.5[医药卫生—消化系统]