Bai Ning, Ying Ting, Li Dejian, Liu Aiguo
Department of Gastroenterology, Huaihe Hospital of Henan University, Kaifeng, China.
Research Institute of Digital and Intelligent Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China.
Front Med (Lausanne). 2025 Mar 12;12:1518540. doi: 10.3389/fmed.2025.1518540. eCollection 2025.
The objective of this study was to examine the correlation between the albumin-corrected anion gap (ACAG) and non-alcoholic fatty liver disease (NAFLD) using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018.
A cross-sectional analysis was conducted, comprising 4,379 participants, who were stratified into two groups: those with NAFLD and those without NAFLD. The baseline characteristics were compared using the most appropriate statistical tests. The relationship between ACAG levels and NAFLD was assessed using generalized linear models, with adjustments made for potential confounding factors. The analysis of threshold effects was conducted using piecewise regression. Furthermore, the relationship between ACAG and NAFLD was investigated in different age groups.
The mean age of participants with non-alcoholic fatty liver disease (NAFLD) was significantly higher than that of non-NAFLD participants (48.88 vs. 43.46 years, < 0.001). The presence of NAFLD was associated with higher levels of ACAG (18.80 ± 0.24 vs. 18.10 ± 0.19, < 0.001). In fully adjusted models, each 1-unit increase in ACAG was associated with a significantly increased risk of NAFLD in participants under 60 years old (: 0.87, 95% CI: 0.05, 1.69, < 0.05). In younger participants, elevated NAFLD risk was observed in those with higher ACAG quartiles ( for trend <0.05). In contrast, no significant associations were identified in participants aged 60 years and older ( for trend >0.05), suggesting the presence of age-specific differences in the relationship between ACAG and NAFLD.
The impact of ACAG on NAFLD is significantly correlated, especially in the age group, where elevated levels of ACAG are associated with increased risk of NAFLD in young people. ACAG may be a potential and reliable biomarker for predicting NAFLD risk in clinical assessment, but its implementation should consider the patient's age factor.
本研究的目的是利用2017 - 2018年美国国家健康与营养检查调查（NHANES）的数据，检验白蛋白校正阴离子间隙（ACAG）与非酒精性脂肪性肝病（NAFLD）之间的相关性。
进行了一项横断面分析，纳入4379名参与者，他们被分为两组：患有NAFLD的参与者和未患有NAFLD的参与者。使用最合适的统计检验比较基线特征。使用广义线性模型评估ACAG水平与NAFLD之间的关系，并对潜在混杂因素进行调整。使用分段回归进行阈值效应分析。此外，还在不同年龄组中研究了ACAG与NAFLD之间的关系。
非酒精性脂肪性肝病（NAFLD）参与者的平均年龄显著高于非NAFLD参与者（48.88岁对43.46岁，<0.001）。NAFLD的存在与较高的ACAG水平相关（18.80±0.24对18.10±0.19，<0.001）。在完全调整模型中，ACAG每增加1个单位，60岁以下参与者患NAFLD的风险显著增加（：0.87，95%CI：0.05，1.69，<0.05）。在年轻参与者中，ACAG四分位数较高者患NAFLD的风险增加（趋势<0.05）。相比之下，60岁及以上参与者未发现显著关联（趋势>0.05），这表明ACAG与NAFLD之间的关系存在年龄特异性差异。
ACAG对NAFLD的影响显著相关，尤其是在该年龄组中，ACAG水平升高与年轻人患NAFLD的风险增加相关。在临床评估中，ACAG可能是预测NAFLD风险的潜在且可靠的生物标志物，但其应用应考虑患者的年龄因素。
