Department of Health Sciences, School of Medicine, Alfonso X University, 28691 Madrid, Spain.
San Juan de Dios Foundation, 28015 Madrid, Spain.
Nutrients. 2024 Jun 23;16(13):1996. doi: 10.3390/nu16131996.
The main objective of this study is to determine the accuracy of different biochemical markers of hepatic steatosis and to correlate liver steatosis with adherence to the Mediterranean diet and level of physical activity.
A cross-sectional study was carried out, including subjects over 50 years of age, with a BMI > 25 kg/m, but excluding any patient with documented hepatic pathology other than hepatic steatosis. Participants were divided into two groups: patients with hepatic steatosis diagnosed by ultrasound (SG) and a control group of individuals without hepatic steatosis (CG). The level of physical activity was recorded by the IPAQ-SF questionnaire and the adherence to the Mediterranean diet was recorded using the PREDIMED questionnaire. Biochemical markers analyzed included the Hepatic steatosis index (HSI), AST-to-Platelet ratio (APRI) and Fibrosis-4 (FIB-4).
A total of 116 patients were included, 71 belonging to the SG and 45 to the CG. A total of 58.6% of the patients showed low adherence to the Mediterranean diet, 35.4% moderate adherence and 6% high adherence. The median estimated physical activity was 495 METS, with most participants reporting light activity. In the SG, significantly higher HSI values were observed ( < 0.001). A cut-off point of a HSI of 40 was established, with a sensitivity of 73.2% and a specificity of 65.8%. Significantly higher FIB-4 values ( = 0.039) were also observed in the SG. A cut-off point of FIB-4 was set at 0.27, with a sensitivity of 69% and a specificity of 57.9%. Patients in the SG showed lower scores in the PREDIMED. Patients in the SG tended to show lower METS scores. However, the higher number of patients with intense activity in the CG group stands out ( = 0.008).
The HSI and FIB-4 showed a significant correlation with liver steatosis. Hepatic steatosis is associated with low adherence to the Mediterranean diet and patients with hepatic steatosis tended to have lower METS scores.
本研究的主要目的是确定不同肝脂肪变性生化标志物的准确性，并将肝脂肪变性与地中海饮食的依从性和身体活动水平相关联。
进行了一项横断面研究，纳入年龄超过 50 岁、BMI>25kg/m2但无除肝脂肪变性以外的任何明确肝脏疾病的患者。参与者分为两组：超声诊断为肝脂肪变性的患者（SG）和无肝脂肪变性的对照组个体（CG）。身体活动水平通过 IPAQ-SF 问卷记录，地中海饮食的依从性通过 PREDIMED 问卷记录。分析的生化标志物包括肝脂肪变性指数（HSI）、天冬氨酸转氨酶与血小板比值（APRI）和纤维化-4（FIB-4）。
共纳入 116 例患者，其中 71 例属于 SG，45 例属于 CG。共有 58.6%的患者对地中海饮食的依从性较低，35.4%为中等依从性，6%为高度依从性。估计的中位体力活动为 495 梅脱，大多数参与者报告轻度活动。在 SG 中，观察到显著更高的 HSI 值（<0.001）。确定 HSI 为 40 的截断值，其敏感性为 73.2%，特异性为 65.8%。在 SG 中也观察到显著更高的 FIB-4 值（=0.039）。设定 FIB-4 的截断值为 0.27，其敏感性为 69%，特异性为 57.9%。SG 中的患者在 PREDIMED 中得分较低。SG 中的患者倾向于表现出较低的梅脱分数。然而，CG 组中高强度活动的患者数量更多（=0.008）。
HSI 和 FIB-4 与肝脂肪变性有显著相关性。肝脂肪变性与地中海饮食依从性低有关，肝脂肪变性患者的 METS 评分往往较低。
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