甘油三酯-葡萄糖指数与甘油三酯/高密度脂蛋白胆固醇比值在代谢相关脂肪性肝病患者中的诊断价值比较：一项回顾性横断面研究。

Comparison of the diagnostic value between triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio in metabolic-associated fatty liver disease patients: a retrospective cross-sectional study.

机构信息

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

出版信息

Lipids Health Dis. 2022 Jun 25;21(1):55. doi: 10.1186/s12944-022-01661-7.

BACKGROUND

The triglyceride and glucose index (TyG) and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) are substitute markers of insulin resistance (IR). In a retrospective cross-sectional study, the authors aimed to compare the efficacy of the two indicators in diagnosing metabolic-associated fatty liver disease (MAFLD) to construct a novel disease diagnosis model.

METHODS

Overall, 229 patients (97 MAFLD and 132 Non-MAFLD at West China Hospital of Sichuan University were included. MAFLD was diagnosed using ultrasonography. Biochemical indexes were collected and analyzed by logistic regression to screen out indicators that were expressed differently in MAFLD patients and healthy controls, which were incorporated into a diagnostic model.

RESULTS

After adjusting for age, sex, and body mass index (BMI), serum alanine transaminase (ALT), aspartate transaminase (AST), AST/ALT (A/A), fasting plasma glucose (FPG), cystatin C (Cys-C), uric acid (URIC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), non-HDL-C, LDL-C/HDL-C, non-HDL-C/HDL-C, TG/HDL-C, TC/HDL-C, TyG, and TyG-BMI were risk factors for MAFLD. The odds ratio of TG/HDL-C and TyG were 5.629 (95%CI: 3.039-10.424) and 182.474 (95%CI: 33.518-993.407), respectively. In identifying MAFLD, TyG, TyG-BMI, TG, and TG/HDL-C were found to be the most vital indexes based on the random forest method, with the area under the curve (AUC) greater than 0.9. In addition, the combination of BMI, ALT, and TyG had a high diagnostic efficiency for MAFLD.

CONCLUSIONS

TyG and TG/HDL-C were potential risk factors for MAFLD, and the former performed better in diagnosing MAFLD. The combination of BMI, ALT, and TyG improved the diagnostic capability for MAFLD.

背景

甘油三酯和葡萄糖指数（TyG）和甘油三酯与高密度脂蛋白胆固醇的比值（TG/HDL-C）是胰岛素抵抗（IR）的替代标志物。在一项回顾性横断面研究中，作者旨在比较这两个指标在诊断代谢相关脂肪性肝病（MAFLD）方面的功效，以构建一种新的疾病诊断模型。

方法

本研究共纳入 229 例患者（97 例 MAFLD 和 132 例非 MAFLD，均来自四川大学华西医院）。MAFLD 采用超声诊断。收集生化指标并进行 logistic 回归分析，筛选出 MAFLD 患者和健康对照组中表达不同的指标，将其纳入诊断模型。

结果

在校正年龄、性别和体重指数（BMI）后，血清丙氨酸转氨酶（ALT）、天门冬氨酸转氨酶（AST）、AST/ALT（A/A）、空腹血糖（FPG）、胱抑素 C（Cys-C）、尿酸（URIC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GGT）、非高密度脂蛋白胆固醇（non-HDL-C）、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇（LDL-C/HDL-C）、非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇（non-HDL-C/HDL-C）、甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）、总胆固醇/高密度脂蛋白胆固醇（TC/HDL-C）、TyG 和 TyG-BMI 是 MAFLD 的危险因素。TG/HDL-C 和 TyG 的比值分别为 5.629（95%CI：3.039-10.424）和 182.474（95%CI：33.518-993.407）。基于随机森林方法，在识别 MAFLD 方面，TyG、TyG-BMI、TG 和 TG/HDL-C 是最重要的指标，曲线下面积（AUC）大于 0.9。此外，BMI、ALT 和 TyG 的组合对 MAFLD 具有较高的诊断效能。