Yu Liang, Bao Shiming, Zhu Feng, Xu Yanyan, Zu Fuqiang, Liu Yanwei, Jiang Runbeng, Chen Wei, Chen Song
Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Department of Emergency Surgery, Tongling People's Hospital, Tongling, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Feb 5;18:345-361. doi: 10.2147/DMSO.S492153. eCollection 2025.
BACKGROUND & AIMS: The aim of this study was to assess the association between the level of lactate dehydrogenase (LDH) and the severity of metabolic syndrome (MetS) and Metabolic Associated Fatty Liver Disease (MAFLD) and the potential diagnostic value of LDH for identifying at-risk metabolic associated steatohepatitis (MASH).
This cross-sectional, real-world retrospective study enrolled a total of 1118 obese patients in the department of bariatric surgery at the Second Affiliated Hospital of Anhui Medical University from January 1, 2018, to December 31, 2021. Of these, 855 were enrolled in the study cohort. MAFLD was defined as the presence or absence of fatty liver disease as suggested by histologic biopsy of liver or postoperative pathology slides, or even hematology, and meets one of the following three conditions: overweight or obesity, T2DM, and metabolic dysfunction (MetS). Serum LDH activity levels were measured in 885 patients, and logistic regression was used to analyze the relationship between LDH and metabolic syndrome and the severity of MAFLD.
In the study cohort of 855 obese patients, 604 (70.6%) had MetS. Patients with MetS (214.1[209.0-219.2]) had significantly higher serum LDH levels than those without MetS (188.7[181.6-195.9]). Particularly, serum LDH level was significantly higher in subjects with hypertension, central obesity, diabetes mellitus or hyperglycemia, elevated levels of triglycerides, or reduced levels of high-density lipoprotein than in those without. Moreover, LDH concentrations were grouped according to the total number of MetS components present in each patient, with Serum LDH levels gradually increase with the total number of MetS components. The MASH subjects had significantly higher LDH levels than the other three less severe non-MASH cohorts, including normal liver, simple fatty steatosis, and B.MASH. Logistic regression showed that LDH was significantly and positively correlated with MAFLD, B.MASH, MASH, at-risk MASH, fibrosis grade ≥1, fibrosis grade ≥2 and fibrosis grade ≥3.
Increased LDH levels were significantly and independently associated with the presence and severity of metabolic syndrome and MAFLD, indicating that LDH could be used as a novel biomarker and clinical predictor of severity of metabolic syndrome and MAFLD.
本研究旨在评估乳酸脱氢酶（LDH）水平与代谢综合征（MetS）及代谢相关脂肪性肝病（MAFLD）严重程度之间的关联，以及LDH对识别代谢相关脂肪性肝炎（MASH）高危患者的潜在诊断价值。
本横断面、真实世界回顾性研究纳入了2018年1月1日至2021年12月31日在安徽医科大学第二附属医院减重外科就诊的1118例肥胖患者。其中，855例纳入研究队列。MAFLD的定义为根据肝脏组织活检或术后病理切片甚至血液学检查提示存在或不存在脂肪性肝病，并符合以下三个条件之一：超重或肥胖、2型糖尿病（T2DM）和代谢功能障碍（MetS）。对885例患者测定血清LDH活性水平，采用逻辑回归分析LDH与代谢综合征及MAFLD严重程度之间的关系。
在855例肥胖患者的研究队列中，604例（70.6%）患有MetS。患有MetS的患者（214.1[209.0 - 219.2]）血清LDH水平显著高于未患MetS的患者（188.7[181.6 - 195.9]）。特别是，患有高血压、中心性肥胖、糖尿病或高血糖、甘油三酯水平升高或高密度脂蛋白水平降低的受试者血清LDH水平显著高于未患这些疾病的受试者。此外，根据每位患者存在的MetS组分总数对LDH浓度进行分组，血清LDH水平随MetS组分总数逐渐升高。MASH受试者的LDH水平显著高于其他三个病情较轻的非MASH队列，包括正常肝脏、单纯性脂肪变性和B.MASH。逻辑回归显示，LDH与MAFLD、B.MASH、MASH、高危MASH、纤维化分级≥1、纤维化分级≥2和纤维化分级≥3显著正相关。
LDH水平升高与代谢综合征和MAFLD的存在及严重程度显著且独立相关，表明LDH可作为代谢综合征和MAFLD严重程度的新型生物标志物和临床预测指标。
