Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Big Data Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Clin Endocrinol (Oxf). 2024 Feb;100(2):116-123. doi: 10.1111/cen.14990. Epub 2023 Dec 26.
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects many populations, and screening out the high-risk populations at an early stage is a challenge. As a sarcopenia index, the relationship between creatinine to cystatin C ratio (CCR) and MASLD remains unclear. This cross-sectional, prospective study aimed to explore the relationship between CCR and MASLD. Design Firstly, explored the correlation between CCR and MASLD in cross-sectional analyses. Then excluded the population with baseeline diagnosis of MASLD and analyzed the association with baseline CCR levels and the onset of MASLD in the population with available follow-up data. Univariate and multivariate logistic regression analyses were used to calculate odds ratios (ORs) to evaluate the association between CCR levels and MASLD.
This study included 368,634 participants from the UK Biobank for cross-sectional and prospective analyses. The demographic characteristics and laboratory measurements of all participants were obtained from the UK Biobank. MASLD was diagnosed according to the multi-society consensus nomenclature. Hepatic steatosis was defined as FLI ≥60.
We grouped the study participants according to CCR tertiles. In cross-sectional analyses, participants in CCR tertile 1 had the highest MASLD risk (OR: 1.070, 95% CI: 1.053-1.088, p < .001). And the similar association was observed in the prospective analyses (CCR tertile 1 OR: 1.340, 95% CI: 1.077-1.660, p = .009; CCR tertile 2 OR: 1.217, 95% CI: 1.021-1.450, p = .029, respectively). After stratification by gender, the significant association between CCR and the onset of MASLD was only observed in males (CCR tertile 1 OR: 1.639, 95% CI: 1.160-2.317, p = .005; CCR tertile 2 OR: 1.322, 95% CI: 1.073-1.628, p = .005, respectively).
Our results indicated that lower CCR was significantly associated with higher risk of MASLD, based on which predictive models can be developed to screen populations at high risk of developing MASLD.
代谢功能障碍相关脂肪性肝病（MASLD）影响许多人群，早期筛选出高危人群是一项挑战。肌酐与胱抑素 C 比值（CCR）作为肌少症指标，与 MASLD 的关系尚不清楚。本横断面、前瞻性研究旨在探讨 CCR 与 MASLD 之间的关系。
首先，在横断面分析中探讨 CCR 与 MASLD 的相关性。然后排除基线诊断为 MASLD 的人群，并分析在有随访数据的人群中，基线 CCR 水平与 MASLD 发病的关系。使用单变量和多变量逻辑回归分析计算比值比（OR）来评估 CCR 水平与 MASLD 之间的关系。
本研究纳入了来自英国生物库的 368634 名参与者进行横断面和前瞻性分析。所有参与者的人口统计学特征和实验室测量值均从英国生物库获得。根据多学会共识命名法诊断 MASLD。肝脂肪变性定义为 FLI≥60。
我们根据 CCR 三分位将研究参与者进行分组。在横断面分析中，CCR 三分位 1 组的 MASLD 风险最高（OR：1.070，95%CI：1.053-1.088，p<0.001）。在前瞻性分析中也观察到了类似的相关性（CCR 三分位 1 OR：1.340，95%CI：1.077-1.660，p=0.009；CCR 三分位 2 OR：1.217，95%CI：1.021-1.450，p=0.029）。按性别分层后，仅在男性中观察到 CCR 与 MASLD 发病之间的显著相关性（CCR 三分位 1 OR：1.639，95%CI：1.160-2.317，p=0.005；CCR 三分位 2 OR：1.322，95%CI：1.073-1.628，p=0.005）。
我们的结果表明，较低的 CCR 与 MASLD 的风险增加显著相关，在此基础上可以开发预测模型来筛选 MASLD 高危人群。
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