School of Medicine, Nankai University, Tianjin, China.
Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China.
J Gastroenterol Hepatol. 2023 Aug;38(8):1316-1324. doi: 10.1111/jgh.16196. Epub 2023 Apr 26.
Many abdominal obesity indices such as waist circumference (WC), lipid accumulation product (LAP), visceral obesity index (VAI), and Chinese VAI (CVAI) have been considered to be associated with the risk of non-alcoholic fatty liver disease (NAFLD), but the association between abdominal obesity indices and the pathological features of NAFLD is uncertain. This study aims to explore the associations between these indices and the pathological features of NAFLD.
A total of 147 patients with biopsy-confirmed NAFLD were enrolled in the final analysis. General information, biochemical tests, and pathological information of patients were collected. VAI, LAP, and CVAI were calculated. Spearman's correlation analysis and logistics regression analysis were applied to assess the relationship between abdominal obesity indices and the pathological features of NAFLD. Receiver operating characteristic curve analyses were used to assess the value of abdominal obesity indices in predicting liver fibrosis and non-alcoholic steatohepatitis.
Non-alcoholic fatty liver disease activity score (NAS) ≥ 5 significantly correlated with WC, LAP, VAI, and CVAI both in univariate and multivariate analyses (P < 0.05). Fibrosis was significantly and positively correlated with WC, LAP, and CVAI (P < 0.05). After adjustment for potential confounders, fibrosis remained associated with CVAI (P < 0.05).
CVAI is significantly associated with the pathological features of NAFLD, and CVAI shows the most superior efficacy in diagnosing fibrosis among these indices.
许多腹部肥胖指数,如腰围(WC)、脂积产物(LAP)、内脏肥胖指数(VAI)和中国内脏肥胖指数(CVAI),已被认为与非酒精性脂肪性肝病(NAFLD)的风险相关,但这些指数与 NAFLD 的病理特征之间的关联尚不确定。本研究旨在探讨这些指数与 NAFLD 病理特征之间的关系。
共纳入 147 例经肝活检证实的 NAFLD 患者进行最终分析。收集患者的一般信息、生化检查和病理信息。计算 VAI、LAP 和 CVAI。应用 Spearman 相关分析和逻辑回归分析评估腹部肥胖指数与 NAFLD 病理特征之间的关系。应用受试者工作特征曲线分析评估腹部肥胖指数预测肝纤维化和非酒精性脂肪性肝炎的价值。
非酒精性脂肪性肝病活动评分(NAS)≥5 与 WC、LAP、VAI 和 CVAI 在单因素和多因素分析中均显著相关(P<0.05)。纤维化与 WC、LAP 和 CVAI 呈显著正相关(P<0.05)。在校正潜在混杂因素后,纤维化仍与 CVAI 相关(P<0.05)。
CVAI 与 NAFLD 的病理特征显著相关,在这些指数中,CVAI 对纤维化的诊断效果最佳。