Peng Hongye, Xiang Jingjing, Pan Liang, Zhao Mo, Chen Bin, Huang Shuxia, Yao Ziang, Liu Jing, Lv Wenliang
Department of Infection, Guang'anmen Hospital, , China Academy of Chinese Medical Sciences, Beijing, China.
Graduate School, Beijing University of Chinese Medicine, 100029, Beijing, China.
BMC Endocr Disord. 2024 Aug 1;24(1):132. doi: 10.1186/s12902-024-01646-w.
Metabolic dysfunction-associated fatty liver disease (MAFLD), a globally prevalent disease, is closely linked to insulin resistance (IR). Physical activity (PA) is closely linked to both MAFLD and IR. We aim to explore the dose-response relationship between metabolic score for IR (METS-IR)/homeostasis model assessment of IR (HOMA-IR) and MAFLD, and investigate the relationship between PA, IR and MAFLD.
Participants from the NHANES study were included in this cross-section study. Logistic regression and the receiver operating characteristic were used to assess the predictive performance of METS-IR/HOMA-IR for MAFLD. Restrictive cubic splines were performed to visualize their dose-response relationship. Decision tree analysis was used to identify high-risk populations of MAFLD. PA's mediating effect in the association between METS-IR/HOMA-IR and MAFLD was also examined.
Of all 1,313 participants, 693 had MAFLD (52.78%). There were a positive association between METS-IR (OR = 1.162, 95% CI = 1.126-1.199) and HOMA-IR (OR = 1.630, 95% CI = 1.431-1.856) and MAFLD risk. The AUCs of the METS-IR and HOMA-IR were 0.831 (0.809, 0.853) and 0.767 (0.741, 0.791), respectively, with significantly different predictive performance (P < 0.001). Adding METS-IR/HOMA-IR to the basic model greatly improved the statistical significance for MAFLD. Five high-risk subgroups were identified for MAFLD. PA mediated about 0.81% and 0.78% (indirect effect/total effect) in the association between METS-IR/HOMA-IR and MAFLD.
MAFLD risk might be predicted by METS-IR/HOMA-IR, among which METS-IR performed better. And PA mediated the association between them. More attention should be paid to the therapeutic effect of lifestyle changes on MAFLD.
代谢功能障碍相关脂肪性肝病（MAFLD）是一种全球流行的疾病，与胰岛素抵抗（IR）密切相关。体力活动（PA）与MAFLD和IR均密切相关。我们旨在探讨胰岛素抵抗代谢评分（METS-IR）/胰岛素抵抗稳态模型评估（HOMA-IR）与MAFLD之间的剂量反应关系，并研究PA、IR和MAFLD之间的关系。
来自美国国家健康与营养检查调查（NHANES）研究的参与者被纳入本横断面研究。采用逻辑回归和受试者工作特征曲线来评估METS-IR/HOMA-IR对MAFLD的预测性能。进行限制性立方样条分析以可视化它们的剂量反应关系。使用决策树分析来确定MAFLD的高危人群。还检验了PA在METS-IR/HOMA-IR与MAFLD之间关联中的中介作用。
在所有1313名参与者中，693人患有MAFLD（52.78%）。METS-IR（比值比[OR]=1.162，95%置信区间[CI]=1.126-1.199）和HOMA-IR（OR=1.630，95%CI=1.431-1.856）与MAFLD风险呈正相关。METS-IR和HOMA-IR的曲线下面积（AUC）分别为0.831（0.809，0.853）和0.767（0.741，0.791），预测性能有显著差异（P<0.001）。在基本模型中加入METS-IR/HOMA-IR大大提高了对MAFLD的统计学显著性。确定了MAFLD的五个高危亚组。PA在METS-IR/HOMA-IR与MAFLD之间的关联中介导了约0.81%和0.78%（间接效应/总效应）。
METS-IR/HOMA-IR可能预测MAFLD风险，其中METS-IR表现更好。并且PA介导了它们之间的关联。应更多关注生活方式改变对MAFLD的治疗效果。
