Luo Shuang, Weng Xiaolu, Xu Jing, Lin Hao
Department of Gastroenterology, Pingyang Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Med (Lausanne). 2024 Aug 15;11:1443811. doi: 10.3389/fmed.2024.1443811. eCollection 2024.
ZJU index, a novel calculation combining blood glucose, body mass index (BMI), lipids and liver functions, is closely related with non-alcoholic fatty liver disease (NAFLD). However, the correlation between ZJU index and hepatic steatosis and liver fibrosis has not been reported in the studies. This study aims to examine the correlation between these variables.
Data from the 2017-2020 NHANES were collected for a cross-sectional study, to explore the linear relationship between ZJU, liver stiffness measurements (LSM) and controlled attenuation parameters (CAP) with multivariate linear regression models. Restricted cubic spline (RCS) regression and threshold effect analyses were utilized to describe the nonlinear relationship. The correlation in subgroups was analyzed based on race, gender, drinking, age, BMI, diabetes and moderate activities.
In this population-based study, a total of 2,122 adults aged 18-80 years old with NAFLD were included. According to the multivariate linear regression analysis, ZJU had a significant positive correlation with liver fibrosis (LSM, = 0.182, 95%CI = 0.154-0.211, < 0.001) and hepatic steatosis (CAP, = 2.35, 95%CI = 2.14-2.56, < 0.001), which was stronger in males. According to the RCS analysis, an inverted L-shaped relationship between ZJU and CAP (inflection point at 60.56) and a J-shaped relationship between ZJU index and LSM (inflection point at 51.27) were observed.
ZJU had a positive correlation with CAP and LSM in American adults with NAFLD. The findings suggest that ZJU may be a valuable biomarker for assessing the severity of liver fibrosis and hepatic steatosis in individuals with NAFLD.
浙江大学（ZJU）指数是一种结合血糖、体重指数（BMI）、血脂和肝功能的新型计算方法，与非酒精性脂肪性肝病（NAFLD）密切相关。然而，ZJU指数与肝脂肪变性和肝纤维化之间的相关性在研究中尚未见报道。本研究旨在探讨这些变量之间的相关性。
收集2017 - 2020年美国国家健康与营养检查调查（NHANES）的数据进行横断面研究，采用多元线性回归模型探讨ZJU、肝脏硬度测量值（LSM）和受控衰减参数（CAP）之间的线性关系。利用受限立方样条（RCS）回归和阈值效应分析来描述非线性关系。基于种族、性别、饮酒情况、年龄、BMI、糖尿病和中等强度活动对亚组中的相关性进行分析。
在这项基于人群的研究中，共纳入了2122名年龄在18 - 80岁的患有NAFLD的成年人。根据多元线性回归分析，ZJU与肝纤维化（LSM，β = 0.182，95%CI = 0.154 - 0.211，P < 0.001）和肝脂肪变性（CAP，β = 2.35，95%CI = 2.14 - 2.56，P < 0.001）呈显著正相关，在男性中这种相关性更强。根据RCS分析，观察到ZJU与CAP之间呈倒L形关系（拐点在60.56），ZJU指数与LSM之间呈J形关系（拐点在51.27）。
在美国患有NAFLD的成年人中，ZJU与CAP和LSM呈正相关。研究结果表明，ZJU可能是评估NAFLD患者肝纤维化和肝脂肪变性严重程度的一个有价值的生物标志物。
