美国成年人血清尿酸与高密度脂蛋白胆固醇比值与非酒精性脂肪性肝病的关联：一项基于人群的分析。

Association of serum uric acid-to-high-density lipoprotein cholesterol ratio with non-alcoholic fatty liver disease in American adults: a population-based analysis.

作者信息

Xie Yilian, Huang Kai, Zhang Xiangyu, Wu Zhouxiao, Wu Yiyi, Chu Jinguo, Kong Weiliang, Qian Guoqing

机构信息

Department of Infectious Diseases, Ningbo First Hospital, Ningbo, Zhejiang, China.

Department of Hepatology, Ningbo First Hospital, Ningbo, Zhejiang, China.

出版信息

Front Med (Lausanne). 2023 May 15;10:1164096. doi: 10.3389/fmed.2023.1164096. eCollection 2023.

DOI:10.3389/fmed.2023.1164096

PMID:37256087

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10225665/

Abstract

OBJECTIVE

Non-invasive disease indicators are currently limited and need further research due to the increased non-alcoholic fatty liver disease (NAFLD) prevalence worldwide. The serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) has been recognized as a novel inflammatory and metabolic marker. Herein, we explored the correlation between UHR and the risk of NAFLD in-depth.

METHODS

A total of 3,766 participants were included in our survey, and the National Health and Nutrition Examination Survey (NHANES) 2017-2018 cycle provided the cross-sectional study population. Weighted multivariable logistic regression and multivariate linear regression analyses were performed to assess the association between the UHR and the odds of NAFLD and liver steatosis and fibrosis severity, respectively. Moreover, we explored the non-linear relationship between the UHR and NAFLD by the generalized additive model.

RESULTS

NAFLD probabilities were statistically demonstrated to be positively correlated with the UHR (OR = 1.331 per SD increase, 95% CI: 1.100, 1.611). The positive connection of the UHR with NAFLD risk persisted significantly in female subjects but not in male subjects in subgroup analyses stratified by gender. The non-linear relationship analysis demonstrated that a UHR between ~20 and 30% suggested a saturation effect of NAFLD risk. Furthermore, a dramatically positive correlation was found between the UHR and hepatic steatosis severity but not fibrosis. Finally, the receiver operating characteristic analysis suggested that UHR had a better predictive value for NAFLD than either serum uric acid (sUA) or high-density lipoprotein cholesterol (HDL) alone [UHR (area under curve): 0.6910; 95% CI: 0.6737-0.7083; < 0.0001].

CONCLUSION

Our investigation revealed that the elevated UHR level was independently related to an increased NAFLD risk and the severity of liver steatosis in American individuals. The correlation differed according to sex. This non-invasive indicator may enhance the capacity to predict the onset of NAFLD and may uncover alternative therapeutic interventional targets.

摘要

目的

由于全球非酒精性脂肪性肝病（NAFLD）患病率上升，目前非侵入性疾病指标有限，需要进一步研究。血清尿酸与高密度脂蛋白胆固醇比值（UHR）已被公认为一种新的炎症和代谢标志物。在此，我们深入探讨了UHR与NAFLD风险之间的相关性。

方法

我们的调查共纳入3766名参与者，2017 - 2018年周期的美国国家健康与营养检查调查（NHANES）提供了横断面研究人群。进行加权多变量逻辑回归和多变量线性回归分析，分别评估UHR与NAFLD几率以及肝脂肪变性和纤维化严重程度之间的关联。此外，我们通过广义相加模型探讨了UHR与NAFLD之间的非线性关系。

结果

统计学证明NAFLD概率与UHR呈正相关（每标准差增加OR = 1.331，95% CI：1.100，1.611）。在按性别分层的亚组分析中，UHR与NAFLD风险的正相关在女性受试者中显著持续，但在男性受试者中不显著。非线性关系分析表明，UHR在~20%至30%之间提示NAFLD风险存在饱和效应。此外，发现UHR与肝脂肪变性严重程度呈显著正相关，但与纤维化无关。最后，受试者工作特征分析表明，UHR对NAFLD的预测价值优于单独的血清尿酸（sUA）或高密度脂蛋白胆固醇（HDL）[UHR（曲线下面积）：0.6910；95% CI：0.6737 - 0.7083；< 0.0001]。