三酰甘油与高密度脂蛋白胆固醇比值作为非酒精性脂肪性肝病的替代指标：一项横断面研究。
Triglycerides to high-density lipoprotein cholesterol ratio as a surrogate for nonalcoholic fatty liver disease: a cross-sectional study.
机构信息
Department of Endocrinology and Metabolism, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, 100 Haining Road, Shanghai, 200080, China.
Department of Laboratory Medicine, Shanghai Songjiang Center Hospital, Shanghai, 201600, China.
出版信息
Lipids Health Dis. 2019 Feb 2;18(1):39. doi: 10.1186/s12944-019-0986-7.
BACKGROUND
Triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) has been recommended as a surrogate marker for insulin resistance. In the present study, we aimed to investigate the relationship between TG/HDL-C and NAFLD in an apparently healthy population.
METHODS
A total of 18,061 subjects who participated in a health checkup program were included. NAFLD was diagnosed by ultrasonography.
RESULTS
The prevalence rate of NAFLD was 24.8% in the whole population, and progressively increased across the quartiles of TG/HDL-C (4.9, 14.1, 26.8 and 53.5%, respectively, P < 0.001). After adjustment for confounding factors, TG/HDL-C was independently associated with the risk of NAFLD. Compared with the first quartile of TG/HDL-C (Q1), the odds ratios (95% confidence intervals) for NAFLD in the increasing quartiles (Q2-Q4) were 2.1(1.8-2.6), 3.6 (3.0-4.3) and 9.2(7.6-11.1), respectively. In addition, the area under receiver operator characteristic curve (95% confidence interval) of TG/HDL-C for NAFLD was 0.85 (0.84-0.86) in women and 0.79 (0.78-0.80) in men, significantly higher than that of TG, TC, LDL-C, HDL-C, ALT and AST (P < 0.05). The optimal cutoff point of TG/HDL-C for detection of NAFLD was 0.9 in women (sensitivity = 78.8%, specificity = 77.3%) and 1.4 in men (sensitivity = 70.7%, specificity = 73.5%).
CONCLUSIONS
TG/HDL-C is independently associated with NAFLD in apparently healthy individuals and may be used as a surrogate for NAFLD.
背景
甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）的比值（TG/HDL-C）已被推荐为胰岛素抵抗的替代标志物。本研究旨在探讨 TG/HDL-C 与非酒精性脂肪性肝病（NAFLD）在健康人群中的关系。
方法
共纳入 18061 名参加健康体检计划的受试者。NAFLD 通过超声诊断。
结果
全人群中 NAFLD 的患病率为 24.8%，且随着 TG/HDL-C 四分位区间（4.9、14.1、26.8 和 53.5%，P<0.001）逐渐升高。调整混杂因素后，TG/HDL-C 与 NAFLD 的发生风险独立相关。与 TG/HDL-C 四分位区间最低的第一分位（Q1）相比，分位区间（Q2-Q4）的 NAFLD 比值比（95%置信区间）分别为 2.1（1.8-2.6）、3.6（3.0-4.3）和 9.2（7.6-11.1）。此外，女性 TG/HDL-C 预测 NAFLD 的受试者工作特征曲线下面积（95%置信区间）为 0.85（0.84-0.86），男性为 0.79（0.78-0.80），均显著高于 TG、TC、LDL-C、HDL-C、ALT 和 AST（P<0.05）。女性 TG/HDL-C 检测 NAFLD 的最佳截断值为 0.9（敏感性=78.8%，特异性=77.3%），男性为 1.4（敏感性=70.7%，特异性=73.5%）。
结论
在健康人群中，TG/HDL-C 与 NAFLD 独立相关，可作为 NAFLD 的替代标志物。
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