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肥胖指数与肝脂肪变性和纤维化的相关性:来自 NHANES 2017-2018 的证据。

Association of the fat mass index with hepatic steatosis and fibrosis: evidence from NHANES 2017-2018.

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.

Suzhou Clinical Center of Digestive Diseases, Suzhou, 215006, China.

出版信息

Sci Rep. 2024 Mar 23;14(1):6943. doi: 10.1038/s41598-024-57388-1.

Abstract

Limited population-based studies discuss the association between fat mass index (FMI) and the risk of liver diseases. This investigation utilized data from the National Health and Nutrition Examination Survey (NHANES) to examine the linkage between the FMI and liver conditions, specifically steatosis and fibrosis. The study leveraged data from NHANES's 2017-2018 cross-sectional study, employing an oversampling technique to deal with sample imbalance. Hepatic steatosis and fibrosis were identified by vibration-controlled transient elastography. Receiver operating curve was used to assess the relationship of anthropometric indicators, e.g., the FMI, body mass index (BMI), weight-adjusted-waist index (WWI), percentage of body fat (BF%), waist-to-hip ratio (WHR), and appendicular skeletal muscle index (ASMI), with hepatic steatosis and fibrosis. In this study, which included 2260 participants, multivariate logistic regression models, stratified analyses, restricted cubic spline (RCS), and sharp regression discontinuity analyses were utilized. The results indicated that the WHR and the FMI achieved the highest area under the curve for identifying hepatic steatosis and fibrosis, respectively (0.720 and 0.726). Notably, the FMI presented the highest adjusted odds ratio for both hepatic steatosis (6.40 [4.91-8.38], p = 2.34e-42) and fibrosis (6.06 [5.00, 7.37], p = 5.88e-74). Additionally, potential interaction effects were observed between the FMI and variables such as the family income-to-poverty ratio, smoking status, and hypertension, all of which correlated with the presence of liver fibrosis (p for interaction < 0.05). The RCS models further confirmed a significant positive correlation of the FMI with the controlled attenuation parameter and liver stiffness measurements. Overall, the findings underscore the strong link between the FMI and liver conditions, proposing the FMI as a potential straightforward marker for identifying liver diseases.

摘要

基于人群的研究有限,讨论了脂肪质量指数(FMI)与肝脏疾病风险之间的关联。本研究利用国家健康和营养检查调查(NHANES)的数据,检查了 FMI 与肝脏疾病(特别是脂肪变性和纤维化)之间的联系。该研究利用 NHANES 2017-2018 年横断面研究的数据,采用过采样技术来处理样本不平衡。使用振动控制瞬态弹性成像来识别肝脂肪变性和纤维化。接受者操作曲线用于评估人体测量指标(例如 FMI、体重指数(BMI)、体重调整腰围指数(WWI)、体脂肪百分比(BF%)、腰臀比(WHR)和四肢骨骼肌指数(ASMI)与肝脂肪变性和纤维化的关系。在这项纳入 2260 名参与者的研究中,使用了多变量逻辑回归模型、分层分析、限制立方样条(RCS)和锐回归间断性分析。结果表明,WHR 和 FMI 分别在识别肝脂肪变性和纤维化方面获得了最高的曲线下面积(0.720 和 0.726)。值得注意的是,FMI 呈现出肝脂肪变性(6.40 [4.91-8.38],p=2.34e-42)和纤维化(6.06 [5.00, 7.37],p=5.88e-74)的最高调整比值比。此外,在 FMI 与家庭收入贫困比、吸烟状况和高血压等变量之间观察到潜在的交互效应,所有这些变量均与肝纤维化的存在相关(p 交互<0.05)。RCS 模型进一步证实 FMI 与受控衰减参数和肝硬度测量值之间存在显著正相关。总体而言,这些发现强调了 FMI 与肝脏状况之间的紧密联系,提出 FMI 可能是识别肝脏疾病的一个潜在简单标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00c8/10960854/cfaa707f6575/41598_2024_57388_Fig1_HTML.jpg

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