肝脏脂肪变性指数与血糖进展之间的非线性关系：来自中国人群大规模回顾性队列研究的证据

Non-linear relationship between the hepatic steatosis index and glycemic progression: evidence from a large-scale retrospective cohort study in a Chinese population.

作者信息

Cao Changchun, Huo Yongyang, Han Yong, Hu Haofei, Zha Fubing, Wang Yulong

机构信息

Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Futian District, Shenzhen, 518000, Guangdong Province, China.

Department of Rehabilitation, Longgang E.N.T Hospital & Shenzhen Key Laboratory of E.N.T, Institute of Ear Nose Throat (E.N.T), Shenzhen, 518000, Guangdong Province, China.

出版信息

BMC Gastroenterol. 2025 Jul 1;25(1):484. doi: 10.1186/s12876-025-04068-7.

DOI:10.1186/s12876-025-04068-7

PMID:40597738

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12211869/

Abstract

BACKGROUND

The hepatic steatosis index (HSI) is a validated tool for assessing hepatic steatosis. While previous investigations have explored the link between HSI and prediabetes and diabetes, the connection between HSI and glycemic progression is still being explored. This research seeks to clarify the association between HSI and glycemic progression risk among a Chinese demographic.

METHODS

The research encompassed a group of 76,314 Chinese adults from the Rich Healthcare Group who were free of prediabetes at the outset. Cox proportional hazard models were utilized to investigate the connection between the HSI and glycemic progression. Additionally, cubic spline function and smooth curve fitting in the Cox regression framework were applied to identify potential non-linear associations between HSI and glycemic progression.

RESULTS

Multivariable analysis demonstrated that with each incremental unit in the HSI, there was a corresponding 5.4% rise in the risk of glycemic progression among females (HR: 1.054, 95%CI: 1.038-1.071) and a 3.7% increase in males (HR: 1.037, 95% CI: 1.028-1.046). Both genders exhibited a non-linear connection between HSI and the risk of glycemic progression. The inflection points for HSI were determined to be 36.595 for females and 34.328 for males. Within the female population, a significant positive association with glycemic progression risk was noted when HSI levels were below 36.595 (approximately 8.0% increased risk per unit) (HR: 1.080, 95%CI: 1.061-1.099, P < 0.0001), whereas this correlation was not statistically significant at HSI levels exceeding 36.595 (HR: 0.988, 95%CI: 0.960-1.016, P = 0.4010). In the male population, hazard ratios were 1.026 (95%CI: 1.013-1.038) (approximately 2.6% increased risk per unit) below the inflection point and 1.045 (95%CI: 1.034-1.056) (approximately 4.5% increased risk per unit) above it.

CONCLUSION

Elevated HSI demonstrated a positive, non-linear correlation with the risk of glycemic progression, suggesting that maintaining lower HSI levels may mitigate the risk of developing glycemic progression.

摘要

背景

肝脏脂肪变性指数（HSI）是评估肝脏脂肪变性的有效工具。虽然先前的研究探讨了HSI与糖尿病前期和糖尿病之间的联系，但HSI与血糖进展之间的关系仍在探索中。本研究旨在阐明中国人群中HSI与血糖进展风险之间的关联。

方法

该研究纳入了来自瑞尔医疗集团的76314名中国成年人，他们在开始时没有糖尿病前期。采用Cox比例风险模型研究HSI与血糖进展之间的关系。此外，在Cox回归框架中应用三次样条函数和平滑曲线拟合来识别HSI与血糖进展之间潜在的非线性关联。

结果

多变量分析表明，HSI每增加一个单位，女性血糖进展风险相应增加5.4%（HR：1.054，95%CI：1.038 - 1.071），男性增加3.7%（HR：1.037，95%CI：1.028 - 1.046）。男女两性在HSI与血糖进展风险之间均呈现非线性关系。女性HSI的拐点为36.595，男性为34.328。在女性人群中，当HSI水平低于36.595时，与血糖进展风险呈显著正相关（每单位风险增加约8.0%）（HR：1.080，95%CI：1.061 - 1.099，P < 0.0001），而当HSI水平超过36.595时，这种相关性无统计学意义（HR：0.988，95%CI：0.960 - 1.016，P = 0.4010）。在男性人群中，拐点以下的风险比为1.026（95%CI：1.013 - 1.038）（每单位风险增加约2.6%），拐点以上为1.045（95%CI：1.034 - 1.056）（每单位风险增加约4.5%）。