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脂蛋白综合指数作为一种比传统血脂参数更优的非酒精性脂肪性肝病识别标志物。

Lipoprotein Combine Index as a Better Marker for NAFLD Identification Than Traditional Lipid Parameters.

作者信息

Qiu Jiajun, Huang Xin, Kuang Maobin, Yang Ruijuan, Li Jiachong, Sheng Guotai, Zou Yang

机构信息

Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.

Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2024 Jun 25;17:2583-2595. doi: 10.2147/DMSO.S462181. eCollection 2024.

Abstract

PURPOSE

The association between traditional lipid parameters and non-alcoholic fatty liver disease (NAFLD) has been extensively discussed. This study aims to evaluate and compare the lipoprotein combine index (LCI) and traditional lipid parameters [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] to identify NAFLD.

PATIENTS AND METHODS

The analysis included 14,251 participants from the NAfld in the Gifu Area, Longitudinal Analysis (NAGALA). Logistic regression models were employed to calculate standardized odds ratios (ORs) and 95% confidence intervals (CIs) for assessing and comparing the association of LCI and traditional lipid parameters with NAFLD. Additionally, receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC) for LCI and traditional lipid parameters in identifying NAFLD.

RESULTS

After adjusting for various confounders, we found that LCI was positively associated with NAFLD (OR=2.25, 95% CI 1.92-2.63), and this association was stronger than that of traditional lipid parameters [OR: TC1.23, TG1.73 LDL-C1.10]. Further subgroup analyses revealed that the association of LCI with NAFLD was stronger than other traditional lipid parameters in all subgroups, including men and women, overweight/obese [body mass index (BMI)≥25 kg/m] and non-obese (BMI<25 kg/m), and older (age≥45 years) and younger (age<45 years) participants. Additionally, ROC analysis indicated that LCI (AUC=0.8118) had significantly higher accuracy (All DeLong <0.05) in identifying NAFLD compared to traditional lipid parameters (AUC: TC0.6309; TG0.7969; LDL-C0.6941); HDL-C0.7587). Sensitivity analysis further confirmed the robustness of the study findings.

CONCLUSION

This study revealed for the first time a positive correlation between LCI and NAFLD. Compared to traditional lipid parameters, LCI has a higher correlation with NAFLD. Additionally, further ROC analysis demonstrated that LCI had higher accuracy in identifying NAFLD compared to traditional lipid parameters, suggesting that LCI may be a better marker for NAFLD identification than traditional lipid parameters.

摘要

目的

传统脂质参数与非酒精性脂肪性肝病(NAFLD)之间的关联已得到广泛讨论。本研究旨在评估和比较脂蛋白综合指数(LCI)与传统脂质参数[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]以识别NAFLD。

患者与方法

分析纳入了岐阜地区非酒精性脂肪性肝病纵向分析(NAGALA)的14251名参与者。采用逻辑回归模型计算标准化比值比(OR)和95%置信区间(CI),以评估和比较LCI与传统脂质参数与NAFLD的关联。此外,使用受试者工作特征(ROC)曲线计算LCI和传统脂质参数在识别NAFLD时的曲线下面积(AUC)。

结果

在调整各种混杂因素后,我们发现LCI与NAFLD呈正相关(OR = 2.25,95% CI 1.92 - 2.63),且这种关联比传统脂质参数更强[OR:TC 1.23,TG 1.73,LDL-C 1.10]。进一步的亚组分析显示,在所有亚组中,包括男性和女性、超重/肥胖[体重指数(BMI)≥25 kg/m²]和非肥胖(BMI < 25 kg/m²)以及年龄较大(年龄≥45岁)和年龄较小(年龄<45岁)的参与者中,LCI与NAFLD的关联均强于其他传统脂质参数。此外,ROC分析表明,与传统脂质参数相比,LCI(AUC = 0.8118)在识别NAFLD方面具有显著更高的准确性(所有DeLong检验<0.05)(AUC:TC 0.6309;TG 0.7969;LDL-C 0.6941;HDL-C 0.7587)。敏感性分析进一步证实了研究结果的稳健性。

结论

本研究首次揭示了LCI与NAFLD之间的正相关关系。与传统脂质参数相比,LCI与NAFLD的相关性更高。此外,进一步的ROC分析表明,与传统脂质参数相比,LCI在识别NAFLD方面具有更高的准确性,这表明LCI可能是比传统脂质参数更好的NAFLD识别标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e191/11214567/1aff8391d043/DMSO-17-2583-g0001.jpg

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