关键词: 代谢相关性脂肪性肝病, 血脂分析, 脂肪变程度, 诊断

Abstract: Objective The aim of this study was to analyze the blood lipid changes in patients with metabolism-related fatty liver disease (MAFLD). Methods A total of 2210 patients with MAFLD were found in Physical Examination Center, Affiliated Hospital, Liaoning University of Chinese Traditional Medicine, from January to October 2021, including 418 individuals with normal blood lipids, and 1792 cases with abnormal blood lipids. The receiver operating characteristic curve (ROC) was established to evaluate the diagnostic efficacy of blood lipids in predicting steatosis severity of patients with MAFLD. Results The body mass index (BMI) in MAFLD patients with abnormal blood lipids was (32.8±10.8 )kg/m², significantly higher than [(28.4±11.2) kg/m², P＜0.05], the systolic blood pressure was (146.2±21.2 )mmHg, significantly higher than [(106.3±7.3)mmHg, P＜0.05], the diastolic blood pressure was (107.3±11.6 )mmHg, significantly higher than [(88.6±5.2)mmHg, P＜0.05], the fasting plasma glucose was (6.4±1.9)mmol/L, significantly higher than [(6.0±1.5)mmol/L, P＜0.05], serum ALT and GGT levels were (42.2±23.8)U/L and (42.5±30.9 )U/L, both significantly higher than [(38.3±13.7) U/L and (39.3±18.3 )U/L, P＜0.05] in those with normal blood lipids; serum TG, TC and LDL-C levels in mild, moderate and severe MAFLD patients with abnormal blood lipids were significantly higher than, while serum HDL-C level was significantly lower than in those with normal blood lipids (P＜0.05); when blood HDL-C=0.84 mmol/L was set as the cut-off-value, the area under ROC curve (AUC) was 0.72(P＜0.001) in predicting mild MAFLD, with the sensitivity (Se) of 84.8% and the specificity (Sp) of 52.8%; when blood TG=2.71 mmol/L was set as the cut-off-value, the AUC was 0.79(P＜0.001) in predicting moderate MAFLD, with the Se of 75.7% and the Sp of 74.4%; when blood TG=3.35 mmol/L was set as the cut-off-value, the AUC was 0.86(P＜0.001) in predicting severe MAFLD, with the Se of 90.4% and the Sp of 73.9%. Conclusion The MAFLD progression is closely related to blood lipid metabolism disorders, and has influence on blood glucose, BMI and blood pressure. The comprehensive check-up, such as blood biochemical tests and ultrasonography could find MAFLD patients with abnormal blood lipids. The early appropriate intervention might help improve the outcomes of patients with MAFLD.

Key words: Metabolic associated fatty liver disease, Blood lipids, Liver steatosis, Diagnosis