Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, 475004, China.
General Practice Center, The Seventh Affiliated Hospital of Southern Medical University, Foshan, 528244, China.
BMC Gastroenterol. 2021 Dec 19;21(1):482. doi: 10.1186/s12876-021-02072-1.
Lipid metabolism disorders play a critical role in the progression of non-alcoholic fatty liver disease (NAFLD). However, the number of studies on the relationships among blood lipid-related indexes and NAFLD is limited, and few studies have emphasized the comparison of blood lipid-related indexes in the same population to identify the optimal index for NAFLD screening. This study aimed to investigate the relationships among several blood lipid-related indexes and NAFLD, and to find the index with the best screening value for NAFLD.
Based on a general health examination at community health service agencies in the Pearl River Delta region of China in 2015, 3239 women were recruited in this cross-sectional study. The relationships among blood lipid-related indexes and NAFLD were assessed separately by constructing multivariate logistic regression models. Receiver operating characteristic analysis was used to evaluate and compare the screening abilities of the indexes for NAFLD. All data analyses were conducted in SPSS and MedCalc software.
Whether in the crude model or each model adjusted for possible confounding factors, the risk of NAFLD significantly rose with increasing cardiometabolic index (CMI), triglyceride glucose index (TyG), triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C), total cholesterol (TC) to HDL-C ratio (TC/HDL-C) and low-density lipoprotein (LDL-C) to HDL-C ratio (LDL-C/HDL-C). Moreover, the area under the curve (AUC) of CMI was 0.744, which was better than that of TyG (0.725), TG/HDL-C (0.715), TC/HDL-C (0.650), and LDL-C/HDL-C (0.644) (P < 0.001). In addition, the optimal cut-off points were 0.62 for CMI, 8.55 for TyG, 1.15 for TG/HDL-C, 4.17 for TC/HDL-C, and 2.22 for LDL-C/HDL-C.
CMI is easy to obtain, is a recommended index in the screening of NAFLD in women and may be useful for detecting populations that are at high risk of NAFLD.
脂质代谢紊乱在非酒精性脂肪性肝病（NAFLD）的进展中起着关键作用。然而，关于血脂相关指标与 NAFLD 之间关系的研究数量有限，并且很少有研究强调在同一人群中比较血脂相关指标，以确定用于 NAFLD 筛查的最佳指标。本研究旨在探讨几种血脂相关指标与 NAFLD 之间的关系，并找到用于 NAFLD 筛查的最佳指标。
基于 2015 年中国珠江三角洲地区社区卫生服务机构的一般健康检查，本横断面研究纳入了 3239 名女性。通过构建多元逻辑回归模型分别评估血脂相关指标与 NAFLD 之间的关系。采用受试者工作特征分析（ROC 分析）评估和比较这些指标对 NAFLD 的筛查能力。所有数据分析均在 SPSS 和 MedCalc 软件中进行。
无论是在原始模型还是每个调整了可能混杂因素的模型中，NAFLD 的风险均随着心血管代谢指数（CMI）、甘油三酯葡萄糖指数（TyG）、甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）比值（TG/HDL-C）、总胆固醇（TC）与高密度脂蛋白胆固醇（HDL-C）比值（TC/HDL-C）和低密度脂蛋白（LDL-C）与高密度脂蛋白胆固醇（HDL-C）比值（LDL-C/HDL-C）的升高而显著增加。此外，CMI 的曲线下面积（AUC）为 0.744，优于 TyG（0.725）、TG/HDL-C（0.715）、TC/HDL-C（0.650）和 LDL-C/HDL-C（0.644）（P<0.001）。此外，CMI 的最佳截断点为 0.62，TyG 为 8.55，TG/HDL-C 为 1.15，TC/HDL-C 为 4.17，LDL-C/HDL-C 为 2.22。
CMI 易于获取，是女性 NAFLD 筛查的推荐指标，可能有助于检测 NAFLD 高危人群。
