TG/HDL-C对老年非酒精性脂肪性肝病的诊断价值研究  

Study on the diagnostic value of TG/HDL-C for nonalcoholic fatty liver disease in the elderly

作　　者：张辉 杨光 ZHANG Hui;YANG Guang(General Medical Department,Fengtai District Chengshousi Subdistrict Community Health Service Center,Beijing100079,China)

机构地区：[1]北京市丰台区成寿寺街道社区卫生服务中心全科,100079 [2]北京市丰台区成寿寺街道社区卫生服务中心信息科,100079

出　　处：《中国实用医药》2025年第3期15-18,共4页China Practical Medicine

摘　　要：目的观察老年非酒精性脂肪性肝病(NAFLD)患者的外周血甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)变化情况,并探讨其临床意义。方法选取1045例参加老年人(年龄≥65岁)体检并完善超声检查者,将其中688例NAFLD患者作为NAFLD组,357例未患NAFLD者作为非-NAFLD组。检测两组外周血空腹血糖(FBG)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、TG、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、HDL-C水平,计算TG/HDL-C,测量身高、体重,计算体质量指数(BMI)。比较两组性别、年龄、BMI、肝功能、血糖、血脂,分析老年NAFLD患者TG/HDL-C与肝功能的相关性,采用受试者工作特征曲线(ROC曲线)分析TG/HDL-C对老年NAFLD患者的诊断效能。结果NAFLD组性别与非-NAFLD组比较差异无统计学意义(P>0.05);NAFLD组年龄(70.88±5.16)岁低于非-NAFLD组的(72.01±6.25)岁,BMI(26.05±3.15)kg/m^(2)高于非-NAFLD组的(23.44±3.04)kg/m^(2),差异具有统计学意义(P<0.05)。NAFLD组ALT(42.69±14.00)U/L、AST(41.43±9.76)U/L均高于非-NAFLD组的(28.06±9.22)、(29.82±5.61)U/L,差异具有统计学意义(P<0.05);NAFLD组TBIL与非-NAFLD组比较差异无统计学意义(P>0.05)。NAFLD组FBG(6.67±1.94)mmol/L、TG(1.68±1.07)mmol/L、LDL-C(2.84±0.82)mmol/L、TG/HDL-C(1.38±1.23)均高于非-NAFLD组的(6.36±1.83)mmol/L、(1.17±0.52)mmol/L、(2.72±0.85)mmol/L、(0.84±0.55),HDL-C(1.38±0.40)mmol/L低于非-NAFLD组的(1.54±0.40)mmol/L,差异具有统计学意义(P<0.05);NAFLD组TC与非-NAFLD组比较差异无统计学意义(P>0.05)。Pearson相关性分析显示:老年NAFLD患者外周血TG/HDL-C与ALT、AST均呈正相关(P<0.05)。ROC曲线分析显示:TG/HDL-C对老年NAFLD患者诊断的曲线下面积(AUC)为0.70,诊断准确度为中度,标准误为0.02,95%置信区间为(0.674,0.740),最佳截点为0.72,灵敏度为76.6%,特异度为54.8%。结论老年NAFLD患者外周血TG/HDL-C高于健康老年人,与肝功能损伤有关,TG/HDL-C有助于老年NAFLD�Objective To observe the changes of triglycerides to high-density lipoprotein cholesterol ratio(TG/HDL-C)in elderly patients with nonalcoholic fatty liver disease(NAFLD)and explore its clinical significance.Methods A total of 1045 elderly individuals(aged≥65 years)who underwent physical examinations and completed ultrasound examinations were selected.Among them,688 elderly patients with NAFLD were included as NAFLD group,and the remaining 357 elderly individuals without NAFLD as non-NAFLD group.The levels of fasting blood glucose(FBG),alanine aminotrasferase(ALT),aspartate transaminase(AST),total bilirubin(TBIL),TG,low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC)and HDL-C in peripheral blood were detected,TG/HDL-C was calculated,and the height and weight were measured to calculate body mass index(BMI).Gender,age,BMI,liver function,blood glucose and blood lipids were compared between the two groups,and the correlation of TG/HDL-C with liver function in elderly NAFLD patients was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of TG/HDL-C in elderly NAFLD patients.Results There was no significant difference in comparison of gender between NAFLD group and non-NAFLD group(P>0.05).The age of(70.88±5.16)years in NAFLD group was younger than(72.01±6.25)years in non-NAFLD group,and the BMI of(26.05±3.15)kg/m^(2) in NAFLD group was higher than(23.44±3.04)kg/m^(2) in non-NAFLD group.The difference was statistically significant(P<0.05).NAFLD group had ALT of(42.69±14.00)U/L and AST of(41.43±9.76)U/L,which were higher than(28.06±9.22)and(29.82±5.61)U/L in non-NAFLD group,and the difference was statistically significant(P<0.05).There was no significant difference in comparison of TBIL between NAFLD group and non-NAFLD group(P>0.05).NAFLD group had FBG of(6.67±1.94)mmol/L,TG of(1.68±1.07)mmol/L,LDL-C of(2.84±0.82)mmol/L,and TG/HDL-C of(1.38±1.23),which were higher than(6.36±1.83)mmol/L,(1.17±0.52)mmol/L,(2.72±0.85)mmol/L,and(0.84±0.55)in non-NAF

关 键 词：老年 非酒精性脂肪性肝病 肝功能损伤 甘油三酯 高密度脂蛋白胆固醇 

分 类 号：R575.5[医药卫生—消化系统]