Nanjing University of Chinese Medicine, Jiangsu Province.
Encephalopathy Department, The First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui Province.
Eur J Gastroenterol Hepatol. 2024 Aug 1;36(8):1046-1053. doi: 10.1097/MEG.0000000000002801. Epub 2024 Jun 10.
Many children with Wilson's disease are complicated with dyslipidemia. The aim of this study was to investigate the risk factors for the development of fatty liver disease (FLD) in children with Wilson's disease.
We evaluated sex, age, weight, the disease course, treatment course, clinical classification, alanine transaminase (ALT), aspartate transaminase, γ-glutamyl transpeptidase, total biliary acid, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, homocysteine, uric acid, fibrinogen (FBG), creatinine, procollagen III N-terminal propeptide, laminin, hyaluronic acid, type IV collagen, and performed receiver operating characteristic curve analysis to investigate the forecast value of individual biochemical predictors and combined predictive indicators to evaluate FLD in Wilson's disease.
The multivariate logistic regression analysis revealed that ALT [odds ratio (OR), 1.011; 95% confidence interval (CI), 1.004-1.02; P = 0.006], uric acid (OR, 1.01; 95% CI, 1.002-1.018; P = 0.017), FBG (OR, 3.668; 95% CI, 1.145-13.71; P = 0.037), creatinine (OR, 0.872; 95% CI, 0.81-0.925; P < 0.001), and laminin (OR, 1.01; 95% CI, 1.002-1.018; P = 0.017) acted as independent risk factors in Wilson's disease complicated with FLD. The receiver operating characteristic curves for combined predictive indicators demonstrated an area under the curve values of 0.872, which was found to be a significant predictors for FLD in Wilson's disease.
We screened out the most important risk factors, namely ALT, uric acid, creatinine, FBG, and laminin for Wilson's disease complicated with FLD. The joint prediction achieved is crucial for identifying children with Wilson's disease complicated with FLD.
许多威尔逊病患儿伴有血脂异常。本研究旨在探讨威尔逊病患儿发生脂肪肝疾病(FLD)的危险因素。
我们评估了性别、年龄、体重、病程、治疗过程、临床分类、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶、γ-谷氨酰转肽酶、总胆汁酸、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、同型半胱氨酸、尿酸、纤维蛋白原(FBG)、肌酐、III 型前胶原 N 端肽、层粘连蛋白、透明质酸、IV 型胶原,并进行了受试者工作特征曲线分析,以探讨单个生化预测因子和联合预测指标对评估威尔逊病患者 FLD 的预测价值。
多变量 logistic 回归分析显示,ALT[比值比(OR),1.011;95%置信区间(CI),1.004-1.02;P=0.006]、尿酸(OR,1.01;95%CI,1.002-1.018;P=0.017)、FBG(OR,3.668;95%CI,1.145-13.71;P=0.037)、肌酐(OR,0.872;95%CI,0.81-0.925;P<0.001)和层粘连蛋白(OR,1.01;95%CI,1.002-1.018;P=0.017)是威尔逊病合并 FLD 的独立危险因素。联合预测指标的受试者工作特征曲线显示曲线下面积值为 0.872,这是威尔逊病合并 FLD 的重要预测指标。
我们筛选出了威尔逊病合并 FLD 的最重要的危险因素,即 ALT、尿酸、肌酐、FBG 和层粘连蛋白。联合预测对识别威尔逊病合并 FLD 的儿童具有重要意义。