Yang Huanhuan, Chen Guochong, Song Chunli, Li Deming, Ma Qinghua, Chen Guangliang, Li Xinli
School of Public Health, Medical College of Soochow University Preventive Medicine Department, The Third People's Hospital of Xiangcheng District in Suzhou Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, PR China.
Medicine (Baltimore). 2018 Mar;97(13):e0272. doi: 10.1097/MD.0000000000010272.
Presently noninvasive methods were employed to the diagnosis of nonalcoholic fatty liver disease (NAFLD), including fatty liver index (FLI), hepatic steatosis index (HSI), product of fasting triglyceride and glucose levels (TyG), and single nucleotide polymorphism (SNP), whereas the accuracy of those indexes need to be improved. Our study aimed to investigate the feasibility of a new index comprehensive index (CI), consisting of 6 serum biomarkers and anthropometric parameters through multivariate logistic regression analysis, to the earlier detection of NAFLD, and the diagnostic value of 5 SNPs (S1: rs2854116 of apolipoprotein C3 [APOC3], S2: rs4149267 of ATP-binding cassette transporter [ABCA1], S3: rs13702 of lipoprotein lipase [LPL], S4: rs738409 of protein 3 [patatin-like phospholipase domain containing protein 3 (PNPLA3)], S5: rs780094 of glucokinase regulatory protein gene [GCKR]) for NAFLD were also explored. Area under the receiver operating characteristic curves (AUROC) and Youden index (YI) were calculated to assess the diagnostic value. The AUROC of CI was higher than FLI, HSI, and TyG (CI: 0.897, FLI: 0.873, HSI: 0.855, TyG: 0.793). Therefore, CI might be a better index for the diagnosis of NAFLD. Although there had no statistical significance (P = .123), the AUROC and YI were increased when CI combined with rs2854116 (S1) (AUROC = 0.902, YI = 0.6844). The combination of CI with S1 showed even better diagnostic accuracy than CI, which suggests the potential value of rs2854116 for the diagnosis of NAFLD.
目前，非侵入性方法被用于非酒精性脂肪性肝病（NAFLD）的诊断，包括脂肪肝指数（FLI）、肝脂肪变性指数（HSI）、空腹甘油三酯与血糖水平乘积（TyG）以及单核苷酸多态性（SNP），然而这些指标的准确性有待提高。我们的研究旨在通过多因素逻辑回归分析，探讨一种由6种血清生物标志物和人体测量参数组成的新指标综合指数（CI）用于早期检测NAFLD的可行性，并探索5个单核苷酸多态性（S1：载脂蛋白C3 [APOC3] 的rs2854116，S2：ATP结合盒转运体 [ABCA1] 的rs4149267，S3：脂蛋白脂肪酶 [LPL] 的rs13702，S4：蛋白3 [含帕他丁样磷脂酶结构域蛋白3（PNPLA3）] 的rs738409，S5：葡萄糖激酶调节蛋白基因 [GCKR] 的rs780094）对NAFLD的诊断价值。计算受试者工作特征曲线下面积（AUROC）和约登指数（YI）以评估诊断价值。CI的AUROC高于FLI、HSI和TyG（CI：0.897，FLI：0.873，HSI：0.855，TyG：0.793）。因此，CI可能是诊断NAFLD的更好指标。虽然无统计学意义（P = 0.123），但当CI与rs2854116（S1）联合时，AUROC和YI增加（AUROC = 0.902，YI = 0.6844）。CI与S1联合显示出比CI更好的诊断准确性，这表明rs2854116在NAFLD诊断中的潜在价值。
