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甘油三酯葡萄糖指数在非肥胖非酒精性脂肪性肝病中的预测价值

Predictive value of triglyceride glucose index in non-obese non-alcoholic fatty liver disease.

作者信息

Zhu Xiaopeng, Sun Fang, Gao Xia, Liu He, Luo ZhongYan, Sun Yijian, Fan Liqi, Deng Juan

机构信息

Department of Health Management, Daping Hospital, Army Medical University, Chongqing, Chongqing, China.

Department of Health Management, Daping Hospital, Army Medical University, Chongqing, Chongqing, China

出版信息

BMJ Open. 2025 Apr 8;15(4):e083686. doi: 10.1136/bmjopen-2023-083686.

Abstract

OBJECTIVES

A large number of patients with non-obese non-alcoholic fatty liver disease (NAFLD) in China remain undiagnosed and untreated due to insufficient awareness and ineffective pharmacotherapy. Therefore, a convenient, predictive marker and diagnostic tools are imperative. This study aimed to investigate the ability of the triglyceride glucose index (TyG) in predicting non-obese NAFLD.

DESIGN

An observational cross-sectional study.

SETTING

Department of Health Management, large urban academic medical centre and DRYAD database data.

PARTICIPANTS

This study included 456 patients with non-obese NAFLD and matched 456 non-fatty liver controls according to age, sex and body mass index (BMI).

PRIMARY AND SECONDARY OUTCOME MEASURES

The receiver operating characteristic (ROC) curve was used to evaluate the predictive role of the TyG index in non-obese NAFLD. Based on the TyG index, a clinical prediction model for non-obese NAFLD was constructed, then the prediction model was verified by the DRYAD database (n=11 562).

RESULTS

TyG in non-obese NAFLD was higher than that in controls (9.00 (8.66-9.40) vs 8.46 (8.10-8.83), p<0.001). Logistic regression analysis showed that TyG was an independent risk factor for non-obese NAFLD (OR=9.03, 95% CI: 5.46 to 14.94, p<0.001). ROC analysis showed that the area under the curve (AUC) was 0.78, the sensitivity was 82.5%, the specificity was 60.5%. Based on the TyG index, sex, age and BMI, the AUC of the predictive model for non-obese NAFLD was 0.78 (95% CI: 0.75 to 0.81, p<0.001). Using the DRYAD database to verify the prediction model, the AUC of the verification group was 0.85 (95% CI: 0.84 to 0.86, p<0.001).

CONCLUSIONS

The high level of the TyG may be an independent risk factor for non-obese NAFLD. The prediction model for non-obese NAFLD based on the TyG index has good clinical prediction value.

摘要

目的

由于认识不足和药物治疗效果不佳,中国大量非肥胖型非酒精性脂肪性肝病(NAFLD)患者仍未得到诊断和治疗。因此,一种方便、具有预测性的标志物和诊断工具势在必行。本研究旨在探讨甘油三酯葡萄糖指数(TyG)预测非肥胖型NAFLD的能力。

设计

一项观察性横断面研究。

地点

大型城市学术医疗中心健康管理部及DRYAD数据库数据。

参与者

本研究纳入了456例非肥胖型NAFLD患者,并根据年龄、性别和体重指数(BMI)匹配了456例非脂肪肝对照者。

主要和次要观察指标

采用受试者工作特征(ROC)曲线评估TyG指数在非肥胖型NAFLD中的预测作用。基于TyG指数构建非肥胖型NAFLD的临床预测模型,然后通过DRYAD数据库(n = 11562)对预测模型进行验证。

结果

非肥胖型NAFLD患者的TyG高于对照组(9.00(8.66 - 9.40)对8.46(8.10 - 8.83),p < 0.001)。Logistic回归分析显示,TyG是非肥胖型NAFLD的独立危险因素(OR = 9.03,95%CI:5.46至14.94,p < 0.001)。ROC分析显示,曲线下面积(AUC)为0.78,敏感性为82.5%,特异性为60.5%。基于TyG指数、性别、年龄和BMI,非肥胖型NAFLD预测模型的AUC为0.78(95%CI:0.75至0.81,p < 0.001)。使用DRYAD数据库验证预测模型,验证组的AUC为0.85(95%CI:0.84至0.86,p < 0.001)。

结论

TyG水平升高可能是非肥胖型NAFLD的独立危险因素。基于TyG指数的非肥胖型NAFLD预测模型具有良好的临床预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a041/11979504/c77564ba841e/bmjopen-15-4-g001.jpg

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