Xia Jun-Xiang, Zhao Yan-Hua, He He, Liang Shan-Shan, Gan Wei, Li Gui-Xing
Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 Sep;53(5):764-769. doi: 10.12182/20220960102.
To study the application of triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) combined with liver function indexes to predict metabolic-associated fatty liver disease (MAFLD).
A total of 2971 outpatients diagnosed with MAFLD and 2794 healthy controls were enrolled, and their relevant data were collected. Two-sample Mann-Whitney test and binary logistic regression analysis were conducted to study the relationship between TG/HDL-C and MAFLD and to construct combined diagnosis models of MAFLD. The area under the curve () of receiver operating characteristic (ROC) was used to pick out the optimal model.
The TG/HDL-C of MAFLD patients was significantly higher than that of healthy controls. In multivariate analysis, after adjusting for body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, uric acid and creatinine, the odds ratio of TG/HDL-C was 2.356 (95% confidence interval []: 1.028-5.400). Therefore, TG/HDL-C was an independent risk factor for MAFLD. ROC curve analysis showed that the of using TG/HDL-C to predict MAFLD was 0.795 (95% : 0.784-0.807), and when the cut-off value was 1.09, the sensitivity was 0.679 and the specificity was 0.755. The of the diagnosis model established by a combined use of TG/HDL-C, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) was 0.890 (95% : 0.882-0.898), and when the cut-off value was 0.47, the sensitivity and specificity were 0.792 and 0.839, respectively.
TG/HDL-C is an independent risk factor for MAFLD. TG/HDL-C can well predict MAFLD when it is used in combination with ALT, AST, and ALB.
研究甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)联合肝功能指标在预测代谢相关脂肪性肝病(MAFLD)中的应用。
纳入2971例诊断为MAFLD的门诊患者和2794例健康对照者,收集其相关数据。采用两样本曼-惠特尼检验和二元逻辑回归分析研究TG/HDL-C与MAFLD的关系,并构建MAFLD的联合诊断模型。采用受试者工作特征(ROC)曲线下面积(AUC)筛选出最佳模型。
MAFLD患者的TG/HDL-C显著高于健康对照者。多因素分析中,在校正体重指数、收缩压、舒张压、空腹血糖、甘油三酯、高密度脂蛋白胆固醇、尿酸和肌酐后,TG/HDL-C的比值比为2.356(95%置信区间[CI]:1.028 - 5.400)。因此,TG/HDL-C是MAFLD的独立危险因素。ROC曲线分析显示,使用TG/HDL-C预测MAFLD的AUC为0.795(95%CI:0.784 - 0.807),当截断值为1.09时,灵敏度为0.679,特异度为0.755。联合使用TG/HDL-C、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和白蛋白(ALB)建立的诊断模型的AUC为0.890(95%CI:0.882 - 0.898),当截断值为0.47时,灵敏度和特异度分别为0.792和0.839。
TG/HDL-C是MAFLD的独立危险因素。TG/HDL-C与ALT、AST和ALB联合使用时能很好地预测MAFLD。