胰岛素抵抗指数代谢评分在识别高尿酸血症患者的非酒精性脂肪性肝病方面优于甘油三酯与葡萄糖指数。
The Metabolic Score for Insulin Resistance Index is Superior to the Triglyceride and Glucose Index in Identifying Nonalcoholic Fatty Liver Disease in Hyperuricemia Subjects.
作者信息
Shu Yimeng, Huang Guoqing, Mao Yushan
机构信息
Department of Endocrinology, The First Affiliated Hospital of Ningbo University, Ningbo, People's Republic of China.
Health Science Center, Ningbo University, Ningbo, People's Republic of China.
出版信息
Diabetes Metab Syndr Obes. 2023 Dec 28;16:4235-4246. doi: 10.2147/DMSO.S438975. eCollection 2023.
PURPOSE
Hyperuricemia (HUA) is a recognized risk factor for non-alcoholic fatty liver disease (NAFLD). Early diagnosis and the identification of predictive factors are important for the HUA population. This study aimed to investigate the potential relationship between the metabolic score for insulin resistance (METS-IR) index and the triglyceride and glucose (TyG) index with NAFLD in individuals with HUA.
PATIENTS AND METHODS
A total of 5537 HUA participants were included in the study. Hepatic ultrasonography was conducted following the latest diagnostic criteria to diagnose NAFLD. The relationship between the TyG and METS-IR index and NAFLD was evaluated by multivariable logistic regression analysis and restricted cubic spline model (RCS). In addition, the area under the curve (AUC), positive likelihood ratio, and negative likelihood ratio were explored to compare the predictive value of IR surrogates for NAFLD with HUA. The AUCs of the two indicators were compared using the DeLong test.
RESULTS
Multivariable logistic regression analysis revealed that elevated TyG (OR = 2.285, 95% CI: 1.525, 3.428) and METS-IR (OR = 1.242, 95% CI: 1.219, 1.266) indices significantly increase the risk of NAFLD. Meanwhile, the RCS analysis revealed a -log-shaped nonlinear relationship between NAFLD risk and the METS-IR index ( < 0.001), contrasting with the linear association observed with the TyG index ( = 0.763). Notably, the risk of NAFLD demonstrated a significant escalation when the METS-IR index exceeded the threshold of 39.208 (OR=1). Compared to the TyG index (AUC = 0.734, 95% CI: 0.7210.748), the METS-IR index (AUC = 0.821, 95% CI: 0.8100.832) demonstrated superior predictive value for NAFLD in individuals with HUA according to the DeLong test.
CONCLUSION
In the HUA population, the METS-IR index has a higher predictive value for NAFLD than the TyG index, contributing to early diagnosis and disease prevention.
目的
高尿酸血症（HUA）是非酒精性脂肪性肝病（NAFLD）的一个公认危险因素。早期诊断和识别预测因素对HUA人群很重要。本研究旨在探讨胰岛素抵抗代谢评分（METS-IR）指数和甘油三酯与血糖（TyG）指数与HUA个体的NAFLD之间的潜在关系。
患者与方法
本研究共纳入5537名HUA参与者。按照最新诊断标准进行肝脏超声检查以诊断NAFLD。通过多变量逻辑回归分析和受限立方样条模型（RCS）评估TyG和METS-IR指数与NAFLD之间的关系。此外，还探讨了曲线下面积（AUC）、阳性似然比和阴性似然比，以比较IR替代指标对HUA患者NAFLD的预测价值。使用DeLong检验比较两个指标的AUC。
结果
多变量逻辑回归分析显示，TyG指数升高（OR = 2.285，95%CI：1.525，3.428）和METS-IR指数升高（OR = 1.242，95%CI：1.219，1.266）显著增加NAFLD风险。同时，RCS分析显示NAFLD风险与METS-IR指数之间呈倒对数形状的非线性关系（<0.001），这与TyG指数观察到的线性关联形成对比（=0.763）。值得注意的是，当METS-IR指数超过39.208阈值时，NAFLD风险显著升高（OR=1）。根据DeLong检验，与TyG指数（AUC = 0.734，95%CI：0.7210.748）相比，METS-IR指数（AUC = 0.821，95%CI：0.8100.832）对HUA个体的NAFLD具有更高的预测价值。
结论
在HUA人群中，METS-IR指数对NAFLD的预测价值高于TyG指数，有助于早期诊断和疾病预防。
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