Jin Xianjing, Xu Jing, Weng Xiaochun
Department of Ultrasound, Wenzhou Yongjia County Traditional Chinese Medicine Hospital, Wenzhou, China.
Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Med (Lausanne). 2024 Sep 4;11:1428593. doi: 10.3389/fmed.2024.1428593. eCollection 2024.
Based on previous research, elevated fasting blood glucose (FBG) and decreased high-density lipoprotein cholesterol (HDL-C) levels are associated with non-alcoholic fatty liver disease (NAFLD). It is hypothesized that the prevalence of NAFLD may be proportional to the FBG-to-HDL-C ratio (GHR).
In this study, 3,842 participants from the National Health and Nutrition Examination Survey (NHANES) (2013-2020) were investigated. Liver steatosis was assessed using vibration-controlled transient elastography (VCTE). NAFLD was defined as controlled attenuation parameter (CAP) ≥288 dB/m.
After adjusting for race, gender, age, diabetes, BMI, moderate activities, uric acid, albumin, ALT, GGT, ALP, total bilirubin and creatinine, multiple logistic regression analysis indicated a positive correlation between GHR and the prevalence of NAFLD (OR = 1.22, 95% CI = 1.17-1.28). Additionally, multiple linear regression analysis showed a positive correlation between GHR and the severity of liver steatosis according to CA -values ( = 4.97, 95% CI: 4.28, 5.66). According to the subgroup analysis, the correlation was stronger in other race, participants at the age <50 years old and those with non-diabetes. In this study, a non-linear relationship and saturation effect between GHR and the prevalence of NAFLD was also revealed, characterized by an inverted L-shaped curve, with an inflection point of 7.443. Finally, the receiver operating characteristic (ROC) analysis suggested that the area under the curve (AUC) of GHR (AUC = 0.731) significantly exceeded that of FBG and HDL-C.
Elevated GHR levels are independently associated with the severity of liver steatosis and the increased prevalence of NAFLD in American adults.
基于先前的研究，空腹血糖（FBG）升高和高密度脂蛋白胆固醇（HDL-C）水平降低与非酒精性脂肪性肝病（NAFLD）相关。据推测，NAFLD的患病率可能与FBG与HDL-C的比值（GHR）成正比。
在本研究中，对来自美国国家健康与营养检查调查（NHANES）（2013 - 2020年）的3842名参与者进行了调查。使用振动控制瞬时弹性成像（VCTE）评估肝脏脂肪变性。NAFLD定义为受控衰减参数（CAP）≥288 dB/m。
在调整种族、性别、年龄、糖尿病、体重指数、中等强度活动、尿酸、白蛋白、谷丙转氨酶、谷氨酰转肽酶、碱性磷酸酶、总胆红素和肌酐后，多因素逻辑回归分析表明GHR与NAFLD患病率呈正相关（OR = 1.22，95%CI = 1.17 - 1.28）。此外，多因素线性回归分析显示，根据CAP值，GHR与肝脏脂肪变性的严重程度呈正相关（β = 4.97，95%CI：4.28，5.66）。根据亚组分析，在其他种族、年龄<50岁的参与者和非糖尿病患者中，这种相关性更强。在本研究中，还揭示了GHR与NAFLD患病率之间的非线性关系和饱和效应，其特征为倒L形曲线，拐点为7.443。最后，受试者工作特征（ROC）分析表明，GHR的曲线下面积（AUC）（AUC = 0.731）显著超过FBG和HDL-C的曲线下面积。
GHR水平升高与美国成年人肝脏脂肪变性严重程度和NAFLD患病率增加独立相关。
