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丙氨酸转氨酶与血小板指数(APRI)升高与肥胖及不同形式的血脂异常相关:一项回顾性横断面研究

Elevated Alanine Transaminase-to-Platelet Index (APRI) Is Associated with Obesity and Distinct Forms of Dyslipidemia: A Retrospective Cross-Sectional Study.

作者信息

Alshuweishi Yazeed, Alfayez Dalal, Almufarrih Abdulmalik A, Abudawood Arwa, Alyami Hanan, Alshuweishi Faisal A, Al-Sheikh Yazeed A, Alfhili Mohammad A

机构信息

Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia.

Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.

出版信息

J Clin Med. 2024 Sep 23;13(18):5650. doi: 10.3390/jcm13185650.

Abstract

Obesity is a pathological condition and a major risk factor for dyslipidemia, type 2 diabetes, and non-alcoholic fatty liver disease. Recent research highlighted the association of non-invasive serum markers with these conditions but the clinical utility of ALT APRI in obesity and its relationship with dyslipidemia remain unexplored. We examined the association of ALT APRI in 165 non-diabetic adults stratified by BMI and serum lipid parameters. Obese subjects had significantly higher APRI than lean subjects, with an area under the curve (AUC) of 0.65 ( = 0.019). Medians of APRI were significantly increased in subjects with high TG, TG/HDL, TC/HDL, and LDL/HDL and low HDL. Notably, all lipid parameters and ratios were significantly elevated in the highest APRI tertile, compared with patients in the lowest tertile. APRI was weakly yet significantly correlated with BMI (R = 0.032, = 0.022), HDL (R = 0.071), TG/HDL (R = 0.031), TC/HDL (R = 0.063), LDL/HDL (R = 0.072), and TyG index (R = 0.081). While APRI only showed a discriminating capacity for HDL (AUC: 0.69, = 0.003), TG/HDL (AUC: 0.63, = 0.020), LDL/HDL (AUC: 0.68, < 0.001), and TyG index (AUC: 0.65, = 0.037), the highest diagnostic performance of APRI was observed with TC/HDL (AUC: 0.74, < 0.001). Additionally, APRI was a risk factor for high TG (OR: 1.6, = 0.028), low HDL (OR: 2.7, = 0.0002), high TG/HDL (OR: 1.94, = 0.0011), high TC/HDL (OR: 2.3, < 0.0001), high LDL/HDL (OR: 2.2, = 0.0001), and high TyG index (OR: 2.1, = 0.008). Our findings argue for the role of APRI as a potential marker for obesity and dyslipidemia, which requires further confirmation in longitudinal studies.

摘要

肥胖是一种病理状态,也是血脂异常、2型糖尿病和非酒精性脂肪性肝病的主要危险因素。最近的研究强调了非侵入性血清标志物与这些疾病的关联,但丙氨酸氨基转移酶(ALT)与血小板比值指数(APRI)在肥胖中的临床应用及其与血脂异常的关系仍未得到探索。我们研究了165名非糖尿病成年人中ALT APRI与体重指数(BMI)和血脂参数分层之间的关联。肥胖受试者的APRI显著高于瘦受试者,曲线下面积(AUC)为0.65(P = 0.019)。在高甘油三酯(TG)、TG/高密度脂蛋白(HDL)、总胆固醇(TC)/HDL、低密度脂蛋白(LDL)/HDL以及低HDL的受试者中,APRI的中位数显著升高。值得注意的是,与最低三分位数的患者相比,最高APRI三分位数的所有血脂参数和比值均显著升高。APRI与BMI(R = 0.032,P = 0.022)、HDL(R = 0.071)、TG/HDL(R = 0.031)、TC/HDL(R = 0.063)、LDL/HDL(R = 0.072)以及甘油三酯葡萄糖(TyG)指数(R = 0.081)呈弱但显著的相关性。虽然APRI仅对HDL(AUC:0.69,P = 0.003)、TG/HDL(AUC:0.63,P = 0.020)、LDL/HDL(AUC:0.68,P < 0.001)和TyG指数(AUC:0.65,P = 0.037)具有鉴别能力,但APRI在TC/HDL方面表现出最高的诊断性能(AUC:0.74,P < 0.001)。此外,APRI是高TG(比值比:1.6,P = 0.028)、低HDL(比值比:2.7,P = 0.0002)、高TG/HDL(比值比:1.94,P = 0.0011)、高TC/HDL(比值比:2.3,P < 0.0001)、高LDL/HDL(比值比:2.2,P = 0.0001)和高TyG指数(比值比:2.1,P = 0.008)的危险因素。我们的研究结果表明APRI作为肥胖和血脂异常的潜在标志物具有一定作用,这需要在纵向研究中进一步证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abac/11432626/d969d0676551/jcm-13-05650-g001.jpg

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