Liu Peng Ju, Lou Hui Ping, Zhu Yan Ning
Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
Medical Examination Center, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Mar 23;14:1339-1347. doi: 10.2147/DMSO.S302297. eCollection 2021.
The hypertriglyceridemic waist phenotype (HWP) has exhibited a strong association with metabolic syndrome, a condition closely linked with nonalcoholic fatty liver disease (NAFLD). However, no study has investigated whether the HWP can accurately predict NAFLD among premenopausal and postmenopausal women or whether alternative anthropometric indexes could replace waist circumference (WC) in the HWP. We examined the power of phenotypes combining triglyceride (TG) levels with anthropometric indexes such as body mass index (BMI), WC, waist-to-hip ratio, waist-to-height ratio, and percent body fat, to detect NAFLD among premenopausal and postmenopausal women.
We conducted a cross-sectional study of 1125 premenopausal women and 654 postmenopausal women who had received an annual health checkup. For all the participating women, we measured both anthropometric and biochemical indexes, such as serum lipid levels. NAFLD diagnoses were made on the basis of abdominal ultrasonography findings. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the indicators' ability to detect NAFLD.
Among the indicators of hepatic steatosis, the combined phenotypes of TG level (≥1.50 mmol/L) and BMI (≥24.0 kg/m) exhibited the largest AUC (0.841, 95%confidence interval [CI] 0.812-0.871, < 0.001) for premenopausal women, whereas WC alone exhibited the highest predictive potential (0.765, 95% CI 0.729-0.801, < 0.001) for postmenopausal women.
Out of all the phenotypes combining a single anthropometric index with TG level or WC and TG level, the combination of TG level and BMI was the best indicator of NAFLD for premenopausal women. For screening NAFLD in postmenopausal women, WC alone was superior to all other indicators.
高甘油三酯血症腰围表型（HWP）已显示出与代谢综合征密切相关，而代谢综合征与非酒精性脂肪性肝病（NAFLD）紧密相连。然而，尚无研究调查HWP能否准确预测绝经前和绝经后女性的NAFLD，或者在HWP中替代腰围（WC）的其他人体测量指标。我们研究了将甘油三酯（TG）水平与体重指数（BMI）、WC、腰臀比、腰高比和体脂百分比等人体测量指标相结合的表型，在绝经前和绝经后女性中检测NAFLD的效能。
我们对1125名绝经前女性和654名绝经后女性进行了一项横断面研究，这些女性均接受了年度健康检查。对于所有参与研究的女性，我们测量了人体测量指标和生化指标，如血脂水平。NAFLD的诊断基于腹部超声检查结果。采用受试者工作特征曲线和曲线下面积（AUC）来评估指标检测NAFLD的能力。
在肝脂肪变性指标中，TG水平（≥1.50 mmol/L）和BMI（≥24.0 kg/m²）的联合表型在绝经前女性中显示出最大的AUC（0.841，95%置信区间[CI] 0.812 - 0.871，P < 0.001），而对于绝经后女性，单独的WC显示出最高的预测潜力（0.765，95% CI 0.729 - 0.801，P < 0.001）。
在所有将单一人体测量指标与TG水平或WC和TG水平相结合的表型中，TG水平和BMI的组合是绝经前女性NAFLD的最佳指标。对于绝经后女性NAFLD的筛查，单独的WC优于所有其他指标。
