颈围相关指标与非酒精性脂肪性肝病患者代谢、动脉粥样硬化和肝功能生物标志物的相关性：一项横断面研究。
Association of neck circumference-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease: a cross-sectional study.
机构信息
Student Research Committee, Department of Biochemistry and Diet Therapy, Tabriz University of Medical Sciences, Tabriz, Iran.
Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
BMJ Open. 2023 Sep 12;13(9):e073452. doi: 10.1136/bmjopen-2023-073452.
OBJECTIVE
The present study aimed to establish the association of neck circumference (NC)-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease (NAFLD).
DESIGN
Cross-sectional study.
SETTING
Outpatient clinics of Tabriz University of Medical Sciences.
PARTICIPANTS
A total of 175 adult patients with NAFLD diagnosed by abdominal ultrasonography were included in this study. Sociodemographic characteristics, anthropometric measures and metabolic, atherogenic and liver function biomarkers were assessed.
RESULTS
Results on 107 women and 68 men with NAFLD showed that 52%, 45.1% and 2.9% of patients had mild, moderate and severe NAFLD, respectively. There were significant differences in most of the anthropometric indices, serum levels of ferritin, creatinine and uric acid as well as liver enzymes, and Aspartate Aminotransferase (AST) to Platelet Ratio Index (APRI) between the genders (p<0.01). However, no significant differences were found in the glycaemic, lipid profile and atherogenic biomarkers. Both NC and neck-to-height ratio (NHtR) were significantly associated with body mass index (BMI) (p=0.018, p<0.001, respectively), waist circumference (WC) (p<0.001, p=0.044, respectively) and waist-to-hip ratio (WHR) (p<0.001, p=0.026, respectively) while results showed only a significant relationship between neck-to-waist ratio (NWR) with BMI (p<0.001) and WC (p<0.001). Among metabolic factors, there were significant and positive correlations between NC and serum haemoglobin A1c (r=0.198, p<0.001), AST (r=0.300, p<0.001), alanine aminotransferase (ALT) (r=0.348, p<0.001), ferritin (r=0.403, p<0.001) and uric acid (r=0.347, p=0.003) while AST/ALT ratio was inversely related to NC (r=-0.226, p=0.003). APRI, Lipid Accumulation Product Index and also Hepatic Steatosis Index were significantly correlated with NC, NHtR and NWR (p<0.01).
CONCLUSIONS AND RELEVANCE
NC-related indices, particularly NC and NHtR, were correlated with some metabolic and liver function biomarkers (apart from lipid profile and atherogenic factors) in patients with NAFLD.
目的
本研究旨在建立颈围（NC）相关指标与非酒精性脂肪肝（NAFLD）患者代谢、动脉粥样硬化和肝功能生物标志物之间的关联。
设计
横断面研究。
地点
大不里士医科大学门诊。
参与者
本研究共纳入 175 名经腹部超声诊断为 NAFLD 的成年患者。评估了社会人口统计学特征、人体测量学指标以及代谢、动脉粥样硬化和肝功能生物标志物。
结果
对 107 名女性和 68 名男性 NAFLD 患者的结果显示，分别有 52%、45.1%和 2.9%的患者患有轻度、中度和重度 NAFLD。在大多数人体测量学指标、血清铁蛋白、肌酐和尿酸水平以及肝酶和天门冬氨酸氨基转移酶（AST）/血小板比值指数（APRI）方面，性别之间存在显著差异（p<0.01）。然而，血糖、血脂谱和动脉粥样硬化生物标志物之间没有发现显著差异。NC 和颈长与身高比（NHtR）均与体重指数（BMI）显著相关（p=0.018，p<0.001，分别）、腰围（WC）（p<0.001，p=0.044，分别）和腰臀比（WHR）（p<0.001，p=0.026，分别），而结果仅显示颈腰比（NWR）与 BMI（p<0.001）和 WC（p<0.001）之间存在显著关系。在代谢因素中，NC 与血清血红蛋白 A1c（r=0.198，p<0.001）、AST（r=0.300，p<0.001）、丙氨酸氨基转移酶（ALT）（r=0.348，p<0.001）、铁蛋白（r=0.403，p<0.001）和尿酸（r=0.347，p=0.003）呈显著正相关，而 AST/ALT 比值与 NC 呈负相关（r=-0.226，p=0.003）。AST/ALT 比值与 NC、NHtR 和 NWR 显著相关（p<0.01）。
结论和相关性
NC 相关指标，尤其是 NC 和 NHtR，与 NAFLD 患者的一些代谢和肝功能生物标志物（除了血脂谱和动脉粥样硬化因素）相关。
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