甘油三酯血糖指数及HOMA-IR与慢性乙型肝炎患者肝纤维严重程度的相关性分析  

The Association of Triglyceride Glycemic Index and HOMA-IR with the Severit of Hepatic Fibrosis in Patients with Chronic Heatitis B

作　　者：李占霞[1] LI Zhan-xia(Clinical Laboratory,Puyang People’s Hospital,Puyang 457000,Henan Province,China)

机构地区：[1]濮阳市人民医院检验科,河南濮阳457000

出　　处：《罕少疾病杂志》2024年第10期60-62,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的在慢性乙型肝炎(CHB)患者中分析并比较甘油三酯血糖(TyG)指数及HOMA-IR与肝纤维化严重程度的相关性。方法选取我院感染科2018年1月至2021年12月收治及门诊就诊的600例CHB患者为研究对象,根据实时剪切波弹性成像检查的肝脏硬度值(LSM)分为S0S1组(n=184)、S2组(n=145)、S2S3组(n=128)和≥S3组(n=143)。测定所有入选者的空腹血糖、空腹胰岛素、甘油三酯等,计算TyG指数和HOMA-IR。结果与S0S1组相比,S2组、S2S3组和≥S3组TyG指数和HOMA-IR均升高,差别均有统计学意义(P<0.05),并且随着肝纤维化严重程度的增加,TyG指数和HOMA-IR逐渐升高;Pearson相关分析提示,在CHB患者中,LSM与TyG指数(r=0.289,P<0.001)和HOMA-IR(r=0.283,P<0.001)均呈正相关;多元Logistic回归分析提示,TyG指数和HOMA-IR均是肝纤维化严重程度的独立危险因素;ROC曲线分析提示TyG指数对CHB患者发生肝纤维化的预测效能大于HOMA-IR,当TyG指数大于5.33时,其预测肝纤维化发生的敏感度为79.8%,特异度为63.6%。结论TyG指数与CHB患者肝纤维化严重程度密切相关,其对CHB患者发生肝纤维化的预测价值优于HOMA-IR。Objective To investigate and compare the association of triglyceride glucose(TyG)index and HOMA-IR with the severity of hepatic fibrosis in patients with chronic hepatitis B(CHB).Methods A total of 600 CHB patients were enrolled as study subjects by the department of infectious diseases in our hospital from January 2018 to December 2021 and they were divided into the S0S1 group(n=184),S2 group(n=145),S2S3 group(n=128)and≥S3 group(n=143)according to the liver stiffness measurement(LSM)examined by the SWE.Fasting blood glucose,fasting insulin and triglyceride were determined in all subjects.The TyG index and HOMA-IR were calculated.Results Compared with the S0S1 group,the TyG index and HOMA-IR were both increased in the S2 group,S2S3 group and≥S3 group(P<0.05).Moreover,the TyG index and HOMA-IR were gradually increased with the increase in the severity of liver fibrosis.Pearson correlation analysis showed that LSM was positively correlated with the TyG index(r=0.289,P<0.001)and HOMA-IR(r=0.283,P<0.001)in CHB patients.Multiple Logistic regression analysis indicated that the TyG index and HOMA-IR were independent risk factors for the severity of liver fibrosis.ROC curve analysis suggested that TyG index was more effective than HOMA-IR in predicting the liver fibrosis in CHB patients.When the cut-off value of TyG index was 5.33,the sensitivity and specificity of TyG index for predicting liver fibrosis were 78.80%and 69.20%respectively.Conclusion The TyG index is closely related to the severity of liver fibrosis in CHB patients,and its predictive value of liver fibrosis in CHB patients is superior to HOMA-IR.

关 键 词：甘油三酯血糖指数 HOMA-IR 肝纤纤维化 慢性乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]