Qin S, Wang J, Zhou C, Zhang Y, Xu Y, Wang X, Wang S
a Department of Gastroenterology and Hepatology , China-Japan Union Hospital of Jilin University , Changchun , China.
b Department of Urology , the First Hospital of Jilin University , Changchun , China.
Br J Biomed Sci. 2019 Apr;76(2):53-58. doi: 10.1080/09674845.2018.1548743. Epub 2018 Dec 17.
Population-based studies suggest a strong association between the presence of nonalcoholic fatty liver disease (NAFLD) and an increased risk of urolithiasis. However, the available information on the association of the severity of NAFLD with urolithiasis is limited. We hypothesised a link between the severity of NAFLD and the risk of urolithiasis.
We recruited 1527 adult patients with NAFLD who completed a comprehensive health checkup. The severity of NAFLD was measured with AST to platelet ratio (APRI score). Logistic regression analysis was used to detect the association of APRI score with the risk of urolithiasis among NAFLD patients. ROC analysis was used to assess the diagnostic value of APRI score for identifying urolithiasis among NAFLD patients.
Multivariate analysis showed three independent risk factors for urolithiasis: obesity (OR 2.06 95%CI 1.35-3.13), APRI score (OR 1.29 95%CI 1.05-1.59), and serum uric acid (OR 1.07 95%CI 1.05-1.09), suggesting an independent association between the noninvasive staging of liver fibrosis and the risk of urolithiasis in NAFLD patients. A three-variable model (obesity, APRI score, and serum uric acid) with an AUROC of 0.73 (95% CI 0.70-0.75) was significant in identifying urolithiasis.
The severity of NAFLD is associated with the risk of urolithiasis among NAFLD patients. Moreover, a three-variable model (obesity, APRI score, serum uric acid) could serve as a useful tool for identifying individuals at high risk for urolithiasis in these patients.
基于人群的研究表明，非酒精性脂肪性肝病（NAFLD）的存在与尿石症风险增加之间存在密切关联。然而，关于NAFLD严重程度与尿石症关联的现有信息有限。我们推测NAFLD的严重程度与尿石症风险之间存在联系。
我们招募了1527名完成全面健康检查的成年NAFLD患者。使用天冬氨酸转氨酶与血小板比值（APRI评分）来衡量NAFLD的严重程度。采用逻辑回归分析来检测APRI评分与NAFLD患者尿石症风险之间的关联。使用ROC分析来评估APRI评分在识别NAFLD患者尿石症方面的诊断价值。
多变量分析显示尿石症的三个独立危险因素：肥胖（OR 2.06，95%CI 1.35 - 3.13）、APRI评分（OR 1.29，95%CI 1.05 - 1.59）和血清尿酸（OR 1.07，95%CI 1.05 - 1.09），这表明肝纤维化的非侵入性分期与NAFLD患者尿石症风险之间存在独立关联。一个包含肥胖、APRI评分和血清尿酸的三变量模型，其曲线下面积（AUROC）为0.73（95%CI 0.70 - 0.75），在识别尿石症方面具有显著意义。
NAFLD的严重程度与NAFLD患者的尿石症风险相关。此外，一个包含肥胖、APRI评分、血清尿酸的三变量模型可作为识别这些患者中尿石症高危个体的有用工具。
