Li Yang, Wang Yi-Bin, Zhu Min, Du Xiao-Ying, Hou Ying-Ying, Wu Ban-Ban, Sun Yi-Xue
Department of Medical Ultrasound, The First Affiliated Hospital of Bengbu Medical University, Bengbu, 233004, China.
Department of Medical Ultrasound, Xiangya Hospital, Central South University, Changsha, 410008, China.
Curr Med Sci. 2025 May 7. doi: 10.1007/s11596-025-00051-1.
The aim of this study was to examine the relationship between the sonographic hepatorenal index and stroke risk in patients with nonalcoholic fatty liver disease (NAFLD).
From December 2023 to July 2024, 72 NAFLD patients with stroke, 53 stroke-free NAFLD patients, and 54 healthy controls were enrolled in our study. The hepatorenal index was calculated as the ratio of the echo intensity of the liver to that of the renal cortex. The mean brightness values for one region of interest within the right hepatic lobe and the other size-matched region at the same depth of field within the right kidney were obtained with two-dimensional ultrasound and a 1- to 6-MHz convex array probe. Laboratory tests were performed with a Cobas 8000 automatic biochemical analyzer. Univariate and multivariate analyses were adopted to analyze the risk factors for stroke in NAFLD patients.
NAFLD patients had a greater hepatorenal index than healthy controls did (P < 0.05). Additionally, NAFLD patients with stroke had an even greater hepatorenal index than did those with stroke-free NAFLD (P < 0.001). Multivariate regression analysis further revealed that the hepatorenal index was independently associated with stroke risk in NAFLD patients (β = 8.897, P < 0.001) after controlling for age, body mass index, systolic blood pressure, and serum glucose, total cholesterol, alanine transaminase, and creatinine concentrations. Receiver operating characteristic curve analysis revealed a sensitivity of 62.5% and specificity of 95.3% for the hepatorenal index, with a cutoff value of 1.255 and an area under the curve of 0.80.
The increased sonographic hepatorenal index could be an independent predictor of stroke development in patients with NAFLD.
本研究旨在探讨非酒精性脂肪性肝病（NAFLD）患者的超声肝肾指数与中风风险之间的关系。
2023年12月至2024年7月，本研究纳入了72例患有中风的NAFLD患者、53例未发生中风的NAFLD患者以及54名健康对照者。肝肾指数通过肝脏回声强度与肾皮质回声强度之比来计算。使用二维超声和1至6MHz凸阵探头获取右肝叶内一个感兴趣区域以及右肾相同深度处另一个大小匹配区域的平均亮度值。使用Cobas 8000自动生化分析仪进行实验室检测。采用单因素和多因素分析来分析NAFLD患者中风的危险因素。
NAFLD患者的肝肾指数高于健康对照者（P < 0.05）。此外，患有中风的NAFLD患者的肝肾指数比未发生中风的NAFLD患者更高（P < 0.001）。多因素回归分析进一步显示，在控制年龄、体重指数、收缩压以及血清葡萄糖、总胆固醇、丙氨酸转氨酶和肌酐浓度后，肝肾指数与NAFLD患者的中风风险独立相关（β = 8.897，P < 0.001）。受试者工作特征曲线分析显示，肝肾指数的敏感性为62.5%，特异性为95.3%，临界值为1.255，曲线下面积为0.80。
超声肝肾指数升高可能是NAFLD患者中风发生的独立预测指标。
