Yang Jian, Li Chuan Wang, Zhang Jing Ru, Qiu Honglin, Guo Xiu Li, Wang Wei
Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Jun 28;16:1953-1965. doi: 10.2147/DMSO.S415477. eCollection 2023.
Recent advances in perirenal adipose tissue (PAT) highlighted that PAT might involve in the pathogenesis of chronic inflammatory and dysfunctional metabolic diseases. This study assessed the association between perirenal fat thickness (PrFT) and metabolic dysfunction-associated fatty liver disease (MALFD) in type 2 diabetes mellitus (T2DM).
This study comprised 867 eligible participants with T2DM. Trained reviewers collected anthropometric and biochemical measurements. The diagnosis of MAFLD was based on the latest international expert consensus statement. PrFT and fatty liver were evaluated by computed tomography. The visceral fat area (VFA) and subcutaneous fat area (SFA) were measured by bioelectrical impedance analysis. The non-alcoholic fatty liver disease fibrosis score (NFS) and fibrosis-4 (FIB-4) index were used to assess progressive liver fibrosis in MAFLD.
Overall, the prevalence of MAFLD was 62.3% in T2DM. The PrFT in the MAFLD group was statistically increased than in the non-MAFLD group ( < 0.05). Correlation analysis showed that PrFT was significantly correlated with dysfunctional metabolic factors like body mass index, waist circumference, triglycerides, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, uric acid, and insulin resistance. Multiple regression analysis revealed that PrFT was positively correlated with NFS (=0.146, <0.001) and FIB-4 (=0.082, =0.025) in the MAFLD. In contrast, PrFT was negatively correlated with CT (=-0.188, <0.001). Furthermore, PrFT was also significantly associated with MAFLD independent of VFA and SFA, the OR (95% CI) was 1.279 (1.191-1.374). Meanwhile, PrFT also had a good identifying value for MAFLD as VFA. The area under the curve (95% CI) value of PrFT identifying MAFLD was 0.782 (0.751-0.812). The optimal cut-off value of PrFT was 12.6mm, with a sensitivity of 77.8% and specificity of 70.8%.
PrFT was independently associated with MAFLD, NFS, and FIB-4 and showed a similar identifying value for MAFLD as VFA, which suggested that PrFT can be used as an alternative index to VFA.
肾周脂肪组织（PAT）的最新研究进展表明，PAT可能参与慢性炎症和代谢功能障碍性疾病的发病机制。本研究评估了2型糖尿病（T2DM）患者肾周脂肪厚度（PrFT）与代谢功能障碍相关脂肪性肝病（MAFLD）之间的关联。
本研究纳入了867名符合条件的T2DM患者。训练有素的评估人员收集了人体测量和生化指标。MAFLD的诊断基于最新的国际专家共识声明。通过计算机断层扫描评估PrFT和脂肪肝。通过生物电阻抗分析测量内脏脂肪面积（VFA）和皮下脂肪面积（SFA）。使用非酒精性脂肪性肝病纤维化评分（NFS）和纤维化-4（FIB-4）指数评估MAFLD中的肝纤维化进展。
总体而言，T2DM患者中MAFLD的患病率为62.3%。MAFLD组的PrFT在统计学上高于非MAFLD组（<0.05）。相关性分析表明，PrFT与体重指数、腰围、甘油三酯、高密度脂蛋白胆固醇、收缩压、舒张压、尿酸和胰岛素抵抗等代谢功能障碍因素显著相关。多元回归分析显示，在MAFLD中，PrFT与NFS（=0.146，<0.001）和FIB-4（=0.082，=0.025）呈正相关。相比之下，PrFT与CT呈负相关（=-0.188，<0.001）。此外，PrFT还与MAFLD独立相关，不受VFA和SFA影响，OR（95%CI）为1.279（1.191-1.374）。同时，PrFT对MAFLD的识别价值与VFA相当。PrFT识别MAFLD的曲线下面积（95%CI）值为0.782（0.751-0.812）。PrFT的最佳截断值为12.6mm，敏感性为77.8%，特异性为70.8%。
PrFT与MAFLD、NFS和FIB-4独立相关，对MAFLD的识别价值与VFA相似，这表明PrFT可作为VFA的替代指标。
