新提出的代谢性内脏脂肪评分是一种识别非酒精性脂肪肝的可靠工具，需要注意两性的年龄特异性影响。
The newly proposed Metabolic Score for Visceral Fat is a reliable tool for identifying non-alcoholic fatty liver disease, requiring attention to age-specific effects in both sexes.
机构信息
Department of Internal Medicine, Medical College of Nanchang University, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China.
Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
出版信息
Front Endocrinol (Lausanne). 2023 Nov 27;14:1281524. doi: 10.3389/fendo.2023.1281524. eCollection 2023.
OBJECTIVE
The newly proposed Metabolic Visceral Fat Score (METS-VF) is considered a more effective measure for visceral adipose tissue (VAT) than other obesity indicators. This study aimed to reveal the association between METS-VF and non-alcoholic fatty liver disease (NAFLD), and its variations across age groups within both sexes.
METHODS
Data from 14,251 medical examiners in the NAGALA project were employed in this study. 3D fitted surface plots were constructed based on multivariate logistic regression models to visualize the isolated and combined effects of aging and METS-VF on NAFLD. Receiver operating characteristic curve (ROC) analysis was conducted to compare the diagnostic performance of METS-VF with other VAT surrogate markers in predicting NAFLD.
RESULTS
The results of multivariate logistic regression analysis showed that each unit increase in METS-VF was independently associated with a 333% and 312% increase in the odds of NAFLD in males and females, respectively. Additionally, the 3D fitted surface plot showed that age significantly influenced the association between METS-VF and the odds of NAFLD in both sexes, as follows: (i) In males, when METS-VF was less than 6.2, the METS-VF-related odds of NAFLD increased gradually with age in the 20-45 age group, reached a plateau in the 45-65 age group, and then decreased in the group above 65 years old; however, when male METS-VF exceeded 6.2, aging and METS-VF combined to further increase the odds of NAFLD in all age groups, particularly in the 45-65 age group. (ii) In females, aging seemed to reduce METS-VF-related odds of NAFLD in the 18-40 age group, but significantly increased it in the 40-60 age group, particularly for those with higher METS-VF levels. Further ROC analysis revealed that compared to other VAT surrogate markers, METS-VF showed the highest diagnostic accuracy for NAFLD in females, especially in those under 45 years of age [area under the curve (AUC) = 0.9256].
CONCLUSIONS
This study firstly revealed a significant positive correlation between METS-VF and the odds of NAFLD, with METS-VF surpassing other VAT surrogate markers in NAFLD diagnosis. Moreover, age significantly influenced the METS-VF-related odds of NAFLD and METS-VF's diagnostic efficacy for NAFLD in both sexes.
目的
新提出的代谢内脏脂肪评分（METS-VF）被认为是一种比其他肥胖指标更能有效衡量内脏脂肪组织（VAT）的方法。本研究旨在揭示 METS-VF 与非酒精性脂肪性肝病（NAFLD）之间的关联，以及其在男女各年龄段的变化。
方法
本研究采用了 NAGALA 项目中 14251 名体检者的数据。基于多变量逻辑回归模型构建了 3D 拟合曲面图，以直观显示老化和 METS-VF 对 NAFLD 的单独和联合影响。采用接收者操作特征曲线（ROC）分析比较了 METS-VF 与其他 VAT 替代标志物在预测 NAFLD 方面的诊断性能。
结果
多变量逻辑回归分析结果表明，METS-VF 每增加一个单位，男性和女性患 NAFLD 的几率分别增加 333%和 312%。此外，3D 拟合曲面图表明，年龄显著影响了 METS-VF 与两性 NAFLD 几率之间的关联，具体表现为：（i）在男性中，当 METS-VF 小于 6.2 时，20-45 岁年龄组中，METS-VF 相关的 NAFLD 几率随年龄的增加而逐渐增加，在 45-65 岁年龄组中达到峰值，然后在 65 岁以上年龄组中降低；然而，当男性 METS-VF 超过 6.2 时，老化和 METS-VF 联合作用进一步增加了所有年龄组中 NAFLD 的几率，尤其是在 45-65 岁年龄组。（ii）在女性中，老化似乎降低了 18-40 岁年龄组中 METS-VF 相关的 NAFLD 几率，但在 40-60 岁年龄组中显著增加，尤其是对于 METS-VF 水平较高的女性。进一步的 ROC 分析显示，与其他 VAT 替代标志物相比，METS-VF 对女性 NAFLD 的诊断准确性最高，尤其是在 45 岁以下的女性中 [曲线下面积（AUC）=0.9256]。
结论
本研究首次揭示了 METS-VF 与 NAFLD 几率之间存在显著的正相关关系，并且在 NAFLD 诊断方面，METS-VF 优于其他 VAT 替代标志物。此外，年龄显著影响了 METS-VF 相关的 NAFLD 几率以及 METS-VF 在两性中的 NAFLD 诊断效能。
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