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非糖尿病患者的HOMA-IR指数,一种早期诊断肝脂肪变性的可靠方法。

HOMA-IR index in non-diabetic patient, a reliable method for early diagnosis of liver steatosis.

作者信息

Motamed Behrang, Kohansal Vajargah Mahsa, Kalantari Saeed, Shafaghi Afshin

机构信息

Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Caspian J Intern Med. 2022 Summer;13(3):519-526. doi: 10.22088/cjim.13.3.519.

Abstract

BACKGROUND

NAFLD is one of the most common liver diseases in the world. HOMA-IR as an indicator of insulin resistance is commonly used in clinical trials in NAFLD patients. The aim of this study was to evaluate the application of HOMA-IR index in the diagnosis of NAFLD.

METHODS

This study was performed on 54 patients with NAFLD and 54 non-NAFLD patients that referred to Razi Hospital in Rasht during 2019-2020. FibroScan was used to diagnose NAFLD in the patient group and ultrasound was used to rule it out in the control group. Metabolic and hepatic parameters were measured for each patient. Data were entered into SPSS 22 software and the necessary analyses were performed.

RESULTS

The mean age of the subjects in the study was 44.01±13.12 years and ranged from 18 to 75 years. 72.2% of people affected by NAFLD were men (p <0.001) .The optimal cut-off point for HOMA-IR in NAFLD was 1.65 with a sensitivity of 89.7% and a specificity of 76.9% in men and 1.90 with a sensitivity of 86.7% and a specificity of 82.9% in women. Overall, the optimal cut-off point for HOMA-IR in NAFLD was 1.75 with a sensitivity of 87.0% and a specificity of 81.5%. In addition, the results showed that there was no significant relationship between steatosis and hepatic fibrosis with HOMA-IR index.

CONCLUSION

The results showed that HOMA-IR can be used as a reliable criterion for early detection of NAFLD.

摘要

背景

非酒精性脂肪性肝病(NAFLD)是世界上最常见的肝脏疾病之一。稳态模型评估胰岛素抵抗(HOMA-IR)作为胰岛素抵抗的指标,常用于NAFLD患者的临床试验。本研究的目的是评估HOMA-IR指数在NAFLD诊断中的应用。

方法

本研究对2019年至2020年期间转诊至拉什特市拉齐医院的54例NAFLD患者和54例非NAFLD患者进行。患者组采用FibroScan诊断NAFLD,对照组采用超声排除NAFLD。测量每位患者的代谢和肝脏参数。数据录入SPSS 22软件并进行必要分析。

结果

研究对象的平均年龄为44.01±13.12岁,年龄范围为18至75岁。NAFLD患者中72.2%为男性(p<0.001)。NAFLD中HOMA-IR的最佳截断点在男性中为1.65,敏感性为89.7%,特异性为76.9%;在女性中为1.90,敏感性为86.7%,特异性为82.9%。总体而言,NAFLD中HOMA-IR的最佳截断点为1.75,敏感性为87.0%,特异性为81.5%。此外,结果显示脂肪变性和肝纤维化与HOMA-IR指数之间无显著关系。

结论

结果表明,HOMA-IR可作为早期检测NAFLD的可靠标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ca/9348208/9e020547df03/cjim-13-519-g001.jpg

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