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脂质代谢指标为非酒精性脂肪性肝病的诊断提供工具:一项全国性调查结果

Lipid metabolism indicators provide tools for the diagnosis of non-alcoholic fatty liver disease: results of a nationwide survey.

作者信息

Wang Yongxin, Fu Chang, Jin Hengwei, Yang Yibo, Li Xiaocong, Liu Kai

机构信息

Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China.

Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2025 Jan 17;15:1468228. doi: 10.3389/fendo.2024.1468228. eCollection 2024.

Abstract

BACKGROUND

Cardiometabolic index (CMI), visceral adiposity index (VAI), and lipid accumulation product (LAP) are lipid-related parameters that reflect central obesity, which is closely associated with the development of non-alcoholic fatty liver disease (NAFLD). The aim of this study is to investigate the effectiveness of these lipid-related parameters in diagnosing NAFLD and to compare their predictive abilities.

METHODS

This population-based study extracted datasets from the National Health and Nutrition Examination Survey (NHANES) 2017-2020. CMI, VAI, and LAP were included in the multivariate logistic model as both continuous and categorical variables to assess the relationship between different lipid-related parameters and NAFLD. To further elucidate this connection, we utilized restricted cubic splines and conducted subgroup analysis. Additionally, the receiver operating characteristics (ROC) curve was employed to evaluate the predictive effectiveness of CMI, VAI, and LAP for NAFLD.

RESULTS

The study included 2,878 adults as the study population, of whom 1,263 participants were diagnosed with NAFLD. When lipid-related parameters were analyzed as continuous variables, they showed a positive correlation with NAFLD. The OR(95%CI) were 2.29(1.81,2.89) for CMI (per 1-unit), 1.40(1.28,1.52) for VAI (per 1-unit) and 1.15(1.11,1.20) for LAP (per 10-units). This correlation remains statistically significant when the lipid-related parameters are analyzed as categorical variables. In descending order of diagnostic capability for NAFLD, the AUC values are as follows: LAP (0.794), CMI (0.752), and VAI (0.719).

CONCLUSION

CMI, VAI, and LAP may be important clinical indicators for identifying NAFLD, with LAP demonstrating the best predictive ability among them.

摘要

背景

心脏代谢指数(CMI)、内脏脂肪指数(VAI)和脂质蓄积产物(LAP)是反映中心性肥胖的脂质相关参数,中心性肥胖与非酒精性脂肪性肝病(NAFLD)的发生密切相关。本研究的目的是探讨这些脂质相关参数在诊断NAFLD中的有效性,并比较它们的预测能力。

方法

这项基于人群的研究从2017 - 2020年国家健康与营养检查调查(NHANES)中提取数据集。CMI、VAI和LAP作为连续变量和分类变量纳入多变量逻辑模型,以评估不同脂质相关参数与NAFLD之间的关系。为了进一步阐明这种联系,我们使用了受限立方样条并进行了亚组分析。此外,采用受试者工作特征(ROC)曲线来评估CMI、VAI和LAP对NAFLD的预测有效性。

结果

该研究纳入了2878名成年人作为研究人群,其中1263名参与者被诊断为NAFLD。当将脂质相关参数作为连续变量进行分析时,它们与NAFLD呈正相关。CMI(每增加1个单位)的OR(95%CI)为2.29(1.81,2.89),VAI(每增加1个单位)为1.40(1.28,1.52),LAP(每增加10个单位)为1.15(1.11,1.20)。当将脂质相关参数作为分类变量进行分析时,这种相关性仍然具有统计学意义。按对NAFLD的诊断能力从高到低排序,AUC值如下:LAP(0.794)、CMI(0.752)和VAI(0.719)。

结论

CMI、VAI和LAP可能是识别NAFLD的重要临床指标,其中LAP的预测能力最佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e92e/11781989/e1636ad3245d/fendo-15-1468228-g001.jpg

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