甘油三酯与高密度脂蛋白胆固醇比值与美国成年人非酒精性脂肪肝和肝纤维化的关系：来自 2017-2020 年全国健康和营养调查的观察性研究。
Association between triglyceride to high-density lipoprotein cholesterol ratio and nonalcoholic fatty liver disease and liver fibrosis in American adults: an observational study from the National Health and Nutrition Examination Survey 2017-2020.
机构信息
Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
出版信息
Front Endocrinol (Lausanne). 2024 Jul 16;15:1362396. doi: 10.3389/fendo.2024.1362396. eCollection 2024.
OBJECTIVE
This study investigated the link between triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and nonalcoholic fatty liver disease (NAFLD) and liver fibrosis in American adults.
METHODS
Information for 6495 participants from the National Health and Nutrition Examination Survey (NHANES) 2017-2020.03 was used for this cross-sectional study. The link between TG/HDL-C ratios and NAFLD and liver fibrosis was assessed by multiple linear regression before evaluating nonlinear correlations based on smoothed curve fitting models. Stratification analysis was then applied to confirm whether the dependent and independent variables displayed a stable association across populations.
RESULTS
TG/HDL-C ratios were positively correlated with NAFLD, with higher ratios being linked to increased prevalence of NAFLD. After adjusting for potential confounders, the odds ratios (OR) for NAFLD patients in the fourth TG/HDL-C quartile were 3.61 (95% confidence interval [CI], 2.94-4.38) ( for trend < 0.001) in comparison with those in the first quartile after adjusting for clinical variables. However, no statistical significance was noted for the ratio for liver fibrosis after adjusting for potential confounders ( for trend = 0.07). A nonlinear correlation between TG/HDL-C ratios and NAFLD was observed based on smoothed curve fitting models. However, a nonlinear relationship between the ratios and liver fibrosis was not established. In subgroup analyses, there was an interaction between smoking status and TG/HDL-C ratio in relation to the prevalence of liver fibrosis ( for interaction < 0.001).
CONCLUSIONS
Among American adults, the TG/HDL-C ratio was noted to be nonlinearly positively associated with the prevalence of NAFLD; however, this relationship was not present in liver fibrosis.
目的
本研究旨在探讨甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值与非酒精性脂肪性肝病（NAFLD）和肝纤维化之间的关系。
方法
本横断面研究使用了来自美国国家健康和营养调查（NHANES）2017-2020.03 的 6495 名参与者的数据。在评估非线性相关关系之前，先使用多元线性回归评估 TG/HDL-C 比值与 NAFLD 和肝纤维化之间的关系，然后根据平滑曲线拟合模型进行非线性相关性评估。接着进行分层分析，以确认依存变量和独立变量在不同人群中的关联是否稳定。
结果
TG/HDL-C 比值与 NAFLD 呈正相关，比值越高，NAFLD 的患病率越高。在调整潜在混杂因素后，与第一四分位组相比，第四四分位组的 NAFLD 患者的比值比为 3.61（95%置信区间[CI]，2.94-4.38）（趋势检验<0.001）。然而，在调整潜在混杂因素后，比值与肝纤维化之间没有统计学意义（趋势检验=0.07）。基于平滑曲线拟合模型，TG/HDL-C 比值与 NAFLD 之间存在非线性相关性。然而，未发现比值与肝纤维化之间存在非线性关系。在亚组分析中，吸烟状态与 TG/HDL-C 比值之间存在交互作用，与肝纤维化的患病率有关（交互检验<0.001）。
结论
在美国成年人中，TG/HDL-C 比值与 NAFLD 的患病率呈非线性正相关；然而，这种关系在肝纤维化中并不存在。
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