Hu Mengmeng, Yang Jingyu, Gao Beibei, Wu Zhoulu, Wu Ying, Hu Dandan, Shen Qiong, Chen Lei
Department of Endocrinology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, No. 126 Daoqian Street, Suzhou, 215000, China.
Diabetol Metab Syndr. 2025 Jan 9;17(1):10. doi: 10.1186/s13098-024-01571-x.
Formerly known as non-alcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD) has now become the most widespread chronic liver disease worldwide. The primary goal of this study is to assess the ability of different indexes (including VAI, TyG, HOMA-IR, BMI, LAP, WHtR, TyG-BMI, TyG-WC, and TyG-WHtR) to predict MASLD in individuals diagnosed with type 2 diabetes mellitus (T2DM), particularly within the Chinese population.
This cross-sectional study involved 1,742 patients with T2DM, recruited from the Metabolic Management Centers (MMC) at Suzhou Municipal Hospital. Abdominal ultrasonography was employed for MASLD diagnosis in patients with T2DM. The predictive accuracy of various screening indexes for MASLD in the Chinese T2DM population was evaluated using logistic regression and receiver operating characteristic (ROC) curve analyses.
Among the 1,742 participants, 996 were diagnosed with MASLD. After adjusting for potential confounding factors, positive associations with the risk of MASLD were found for all the nine indexes. The lipid accumulation product (LAP) exhibited the greatest predictive value for detecting MASLD, with an area under the curve (AUC) of 0.786(95%CI 0.764,0.807), followed by BMI(AUC = 0.785), VAI(AUC = 0.744), TyG(AUC = 0.720), WHtR(AUC = 0.710) and HOMA-IR(AUC = 0.676). The composite Indexes (TyG-BMI, TyG-WC, TyG-WHtR) also showed considerable predictive ability with AUCs of 0.765, 0.752 and 0.748, respectively.
Our results indicated that all nine indexes have favorable correlations with the risk of MASLD, and most of them have a good performance in predicting MASLD. According to our study, LAP was a reliable index for predicting MASLD among Chinese T2DM patients. The exploration of non-invasive screenings will provide significant support for the early detection and diagnosis of MASLD.
代谢功能障碍相关脂肪性肝病(MASLD)曾被称为非酒精性脂肪性肝病(NAFLD),现已成为全球最普遍的慢性肝病。本研究的主要目的是评估不同指标(包括内脏脂肪指数(VAI)、甘油三酯与血糖乘积指数(TyG)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)、脂质蓄积产物(LAP)、腰围身高比(WHtR)、TyG-BMI、TyG-腰围(TyG-WC)和TyG-WHtR)预测2型糖尿病(T2DM)患者中MASLD的能力,特别是在中国人群中。
这项横断面研究纳入了1742例T2DM患者,这些患者来自苏州市立医院代谢管理中心。采用腹部超声对T2DM患者进行MASLD诊断。使用逻辑回归和受试者工作特征(ROC)曲线分析评估中国T2DM人群中各种筛查指标对MASLD的预测准确性。
在1742名参与者中,996人被诊断为MASLD。在调整潜在混杂因素后,发现所有九个指标与MASLD风险均呈正相关。脂质蓄积产物(LAP)在检测MASLD方面表现出最大的预测价值,曲线下面积(AUC)为0.786(95%置信区间0.764,0.807),其次是BMI(AUC = 0.785)、VAI(AUC = 0.744)、TyG(AUC = 0.720)、WHtR(AUC = 0.710)和HOMA-IR(AUC = 0.676)。复合指标(TyG-BMI、TyG-WC、TyG-WHtR)也显示出相当的预测能力,AUC分别为0.765、0.752和0.748。
我们的结果表明,所有九个指标与MASLD风险均具有良好的相关性,且大多数指标在预测MASLD方面表现良好。根据我们的研究,LAP是预测中国T2DM患者中MASLD的可靠指标。对非侵入性筛查的探索将为MASLD的早期检测和诊断提供重要支持。