Wang Qing, Liu Ke, Zhang Tian, Wang Ting, Li Huan, Wang Chang, Chen Jinhu, Ren Luping
Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.
Department of Clinical laboratory, Nanjing Medical College, Nanjing, Jiangsu, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Feb 27;17:913-923. doi: 10.2147/DMSO.S451852. eCollection 2024.
The study estimated the association between NAFLD and SUA/Cr in Chinese non-obese patients with type 2 diabetes mellitus (T2DM) and also investigated mediating effect of TG.
All patients were divided into NAFLD group (n = 420) and non-NAFLD group (n = 347). The differences of biochemical indicators between the two groups were compared. The link between SUA/Cr and other parameters was checked through Spearman correlation analysis. Differences in the incidence rate of NAFLD between SUA/Cr and TG 3 tertile subgroups were tested by chi-squared. To explore the independent influence of SUA/Cr and TG on NAFLD, logistic regression was performed. The predictive value of SUA/Cr and SUA/Cr combined with BMI for NAFLD was analyzed using ROC curves. In addition, to confirm whether TG has a mediating effect on the link of SUA/Cr and NAFLD, we conducted a mediating analysis.
NAFLD group had higher SUA/Cr values than individuals without NAFLD (P < 0.01). SUA/Cr was linked with TC and TG (r = 0.081, 0.215 respectively). NAFLD prevalence increased progressively from quartile 1 to quartile 3 of SUA/Cr (44% vs 57% vs 62%). Prevalence of NAFLD increased from quartile 1 to quartile 3 of TG (35.8% vs 58.7% vs 69.9%). Analysis of the logistic regression revealed that SUA/Cr and TG were statistically linked with NAFLD. The ROC curve pointed out that the area under the curve (AUC), sensitivity and specificity of SUA/Cr were 0.59, 0.629 and 0.522, respectively. The AUC, sensitivity and specificity for SUA/Cr combined with BMI were 0.719, 0.644 and 0.677, separately. The mediation analysis showed a statistically direct effect of SUA/Cr on NAFLD (β=0.148, 95% CI: 0.0393, 0.2585). The function of SUA/Cr on NAFLD partially mediated by TG (β=0.1571, 95% CI: 0.0704, 0.2869).
SUA/Cr was significantly associated with NAFLD in non-obese T2DM patients, and TG partially mediated this association. SUA/Cr can be applied to predict for NAFLD.
本研究评估了中国非肥胖2型糖尿病（T2DM）患者中，非酒精性脂肪性肝病（NAFLD）与尿酸/肌酐（SUA/Cr）之间的关联，并探讨了甘油三酯（TG）的中介作用。
将所有患者分为NAFLD组（n = 420）和非NAFLD组（n = 347）。比较两组间生化指标的差异。通过Spearman相关性分析检验SUA/Cr与其他参数之间的联系。采用卡方检验SUA/Cr和TG三分位数亚组之间NAFLD发病率的差异。为探讨SUA/Cr和TG对NAFLD的独立影响，进行逻辑回归分析。使用ROC曲线分析SUA/Cr以及SUA/Cr联合体重指数（BMI）对NAFLD的预测价值。此外，为证实TG是否在SUA/Cr与NAFLD的关联中起中介作用，我们进行了中介分析。
NAFLD组的SUA/Cr值高于无NAFLD的个体（P < 0.01）。SUA/Cr与总胆固醇（TC）和TG相关（r分别为0.081和0.215）。NAFLD患病率从SUA/Cr的第1四分位数到第3四分位数逐渐增加（44%对57%对62%）。NAFLD患病率从TG的第1四分位数到第3四分位数增加（35.8%对58.7%对69.9%）。逻辑回归分析显示，SUA/Cr和TG与NAFLD在统计学上相关。ROC曲线指出，SUA/Cr的曲线下面积（AUC）、敏感性和特异性分别为0.59、0.629和0.522。SUA/Cr联合BMI的AUC、敏感性和特异性分别为0.719、0.644和0.677。中介分析显示，SUA/Cr对NAFLD有统计学上的直接效应（β = 0.148，95%置信区间：0.0393，0.2585）。SUA/Cr对NAFLD的作用部分由TG介导（β = 0.1571，95%置信区间：0.0704，0.2869）。
在非肥胖T2DM患者中，SUA/Cr与NAFLD显著相关，且TG部分介导了这种关联。SUA/Cr可用于预测NAFLD。
