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TyG-GGT 是超重或肥胖个体肝纤维化进展的可靠无创预测指标。

TyG-GGT is a Reliable Non-Invasive Predictor of Advanced Liver Fibrosis in Overweight or Obese Individuals.

机构信息

General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.

The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Obes Surg. 2024 Apr;34(4):1333-1342. doi: 10.1007/s11695-024-07139-y. Epub 2024 Mar 1.

Abstract

BACKGROUND

Liver fibrosis is a predisposing factor for liver cancer. This study will investigate the predictive role of the Triglyceride-glucose and Gamma-glutamyl transferase index (TyG-GGT) as a non-invasive indicator of advanced liver fibrosis in individuals with obesity or overweight.

METHOD

We enrolled patients who underwent metabolic and bariatric surgery as well as intraoperative liver biopsies at Zhejiang provincial people's hospital from August 2020 to March 2023. Clinical characteristics, comorbidities, laboratory data, and pathological variables of patients were collected and analysed. Then, we conducted logistics regression model to compare the performance of the TyG-GGT index with other 4 non-invasive models.

RESULTS

A total of 65 patients were included in this study. 43(66.2%) of them were female, with the mean body mass index (BMI) of 39.0 ± 7.3 kg/m2. Meanwhile, 24(36.9%) patients were diagnosed with diabetes. Advanced liver fibrosis were observed in 16.9% of patients, while liver cirrhosis was found in 4.6% of patients. The multivariable logistics regression showed that TyG-GGT was an independent risk factor of advanced liver fibrosis (OR = 6.989, P = 0.049). Additionally, compared to another 4 non-invasive liver fibrosis models (NFS = 0.66, FIB4 = 0.65, METS-IR = 0.68, APRI = 0.65), TyG-GGT exhibits the highest AUC value of 0.75.

CONCLUSIONS

More than one-third of patients undergoing metabolic and bariatric surgery are afflicted with nonalcoholic steatohepatitis (NASH), and a significant proportion exhibit advanced fibrosis. TyG-GGT was a potentially reliable predictor for screening individuals with overweight or obesity at high risk of advanced liver fibrosis, thus providing clinical guidance for early intervention in this targeted group.

摘要

背景

肝纤维化是肝癌的一个前置因素。本研究将探讨甘油三酯-葡萄糖和γ-谷氨酰转移酶指数(TyG-GGT)作为肥胖或超重个体中晚期肝纤维化的非侵入性指标的预测作用。

方法

我们纳入了 2020 年 8 月至 2023 年 3 月在浙江省人民医院接受代谢和减重手术以及术中肝活检的患者。收集并分析了患者的临床特征、合并症、实验室数据和病理变量。然后,我们进行了逻辑回归模型比较,以比较 TyG-GGT 指数与其他 4 种非侵入性模型的性能。

结果

本研究共纳入 65 例患者,其中 43 例(66.2%)为女性,平均体重指数(BMI)为 39.0±7.3 kg/m2。同时,24 例(36.9%)患者患有糖尿病。16.9%的患者存在晚期肝纤维化,4.6%的患者存在肝硬化。多变量逻辑回归显示,TyG-GGT 是晚期肝纤维化的独立危险因素(OR=6.989,P=0.049)。此外,与其他 4 种非侵入性肝纤维化模型(NFS=0.66、FIB4=0.65、METS-IR=0.68、APRI=0.65)相比,TyG-GGT 具有最高的 AUC 值 0.75。

结论

接受代谢和减重手术的患者中超过三分之一患有非酒精性脂肪性肝炎(NASH),且很大一部分存在晚期纤维化。TyG-GGT 可能是筛查超重或肥胖个体中晚期肝纤维化高危人群的可靠预测指标,为该目标人群的早期干预提供临床指导。

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