Organ Transplant Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China.
Front Endocrinol (Lausanne). 2024 Jan 8;14:1287916. doi: 10.3389/fendo.2023.1287916. eCollection 2023.
Nonalcoholic fatty liver disease (NAFLD) affects approximately 30% of individuals globally. Both serum glucose and albumin were demonstrated to be potential markers for the development of NAFLD. We hypothesized that the risk of NAFLD may be proportional to the glucose-to-albumin ratio (GAR).
Based on information from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, it was determined that GAR was associated with an increased risk of NAFLD and liver fibrosis utilizing weighted multivariable logistic regression. Participants with a fatty liver index (FLI) over 60 were identified with NAFLD, and those with an NAFLD fibrosis score (NFS) >0.676 with evidence of NAFLD were labeled with advanced hepatic fibrosis (AHF). The liver biopsy was utilized to verify the relationship between GAR and FLD in our center cohort. Mendelian randomization analysis investigated the genetic relationship between GAR and NAFLD.
Of 15,534 eligible participants, 36.4% of participants were identified as NAFLD without AHF. GAR was positively correlated with the probability of NAFLD following full adjustment for possible variables (OR = 1.53, 95% CI: 1.39-1.67). It was confirmed that patients with NAFLD and AHF had an inferior prognosis. The relationship between GAR and NFS was favorable (R = 0.46, P< 0.0001), and NAFLD patients with a higher GAR tended to develop poor survival. In our center cohort, the association between GAR and NAFLD was verified.
Among participants without diabetes, greater GAR was linked to higher risks of NAFLD. In addition, NAFLD patients with higher GAR tended to develop liver fibrosis and adverse outcomes.
非酒精性脂肪性肝病（NAFLD）影响着全球约 30%的人群。血清葡萄糖和白蛋白均被证实是 NAFLD 发展的潜在标志物。我们推测，NAFLD 的风险可能与葡萄糖/白蛋白比值（GAR）成正比。
基于 1999 年至 2018 年国家健康和营养检查调查（NHANES）的数据，利用加权多变量逻辑回归确定 GAR 与 NAFLD 和肝纤维化风险增加相关。使用脂肪性肝病指数（FLI）超过 60 识别患有 NAFLD 的患者，NAFLD 纤维化评分（NFS）>0.676 且存在 NAFLD 的患者被标记为存在进展性肝纤维化（AHF）。我们中心的队列研究利用肝活检来验证 GAR 与 FLD 之间的关系。孟德尔随机化分析研究了 GAR 与 NAFLD 之间的遗传关系。
在 15534 名符合条件的参与者中，36.4%的参与者被确定为无 AHF 的 NAFLD。在充分调整可能的变量后，GAR 与 NAFLD 的概率呈正相关（OR=1.53，95%CI：1.39-1.67）。患有 NAFLD 和 AHF 的患者预后较差。GAR 与 NFS 之间的关系良好（R=0.46，P<0.0001），GAR 较高的 NAFLD 患者往往预后不良。在我们中心的队列中，验证了 GAR 与 NAFLD 之间的关系。
在无糖尿病的参与者中，GAR 越高，NAFLD 的风险越高。此外，GAR 较高的 NAFLD 患者往往会发展为肝纤维化和不良结局。
