Li Shaobo, Lu Jing, Gu Geng, Bai Wenkun, Ye Yafen, Bao Yuqian, Yu Haoyong, Han Junfeng
Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Front Physiol. 2021 Apr 7;12:664100. doi: 10.3389/fphys.2021.664100. eCollection 2021.
The simultaneous assessment of visceral adiposity and muscle mass might be useful to monitor the risk of non-alcoholic fatty liver disease (NAFLD) progression in large population. We aimed to investigate the value of serum creatinine-to-cystatin C ratio (CCR) in evaluating these two parameters and predicting liver steatosis and fibrosis.
154 overweight/obese inpatients (49 males, 105 females) scheduled for bariatric surgery and 49 non-overweight/obese volunteers (18 males, 31 females) responded to the hospital advertisement were involved in the cross-sectional study. Liver steatosis and fibrosis were diagnosed with transient elastography (TE). The psoas muscle area (PMA) and visceral fat area (VFA) were measured using magnetic resonance imaging.
The body mass index, insulin resistance, and lipid profiles showed significant differences between the CCR tertiles. Multiple regression analyses revealed that the CCR was significantly associated with the controlled attenuation parameter (β = -0.30, = 0.006 in males; β = -0.19, = 0.017 in females) and liver stiffness measurements in males (β = -0.246, = 0.044). A low CCR was associated with moderate-to-severe steatosis ( < 0.001), significant liver fibrosis ( < 0.01), and excellent predictive power for these two conditions ( < 0.01). The CCR had a negative correlation with the VFA/PMA ratio ( = -0.584, < 0.001 in males; = -0.569, < 0.001 in females).
The CCR is a serum marker for muscle-adjusted visceral fat mass, and a low CCR is associated with an increased risk of progressive NAFLD.
同时评估内脏脂肪量和肌肉量可能有助于监测大量人群中非酒精性脂肪性肝病（NAFLD）进展的风险。我们旨在研究血清肌酐与胱抑素C比值（CCR）在评估这两个参数以及预测肝脂肪变性和肝纤维化方面的价值。
154名计划接受减肥手术的超重/肥胖住院患者（49名男性，105名女性）和49名响应医院广告的非超重/肥胖志愿者（18名男性，31名女性）参与了这项横断面研究。采用瞬时弹性成像（TE）诊断肝脂肪变性和肝纤维化。使用磁共振成像测量腰大肌面积（PMA）和内脏脂肪面积（VFA）。
CCR三分位数之间的体重指数、胰岛素抵抗和血脂谱存在显著差异。多元回归分析显示，CCR与男性的控制衰减参数显著相关（β = -0.30，P = 0.006；女性β = -0.19，P = 0.017）以及男性的肝脏硬度测量值相关（β = -0.246，P = 0.044）。低CCR与中度至重度脂肪变性（P < 0.001）、显著肝纤维化（P < 0.01）以及对这两种情况的良好预测能力相关（P < 0.01）。CCR与VFA/PMA比值呈负相关（男性r = -0.584，P < 0.001；女性r = -0.569，P < 0.001）。
CCR是经肌肉调整的内脏脂肪量的血清标志物，低CCR与进展性NAFLD风险增加相关。
