实用肝脏病杂志 ›› 2024, Vol. 27 ›› Issue (3): 361-365.doi: 10.3969/j.issn.1672-5069.2024.03.011

• 非酒精性脂肪性肝病 • 上一篇    下一篇

体检人群血浆致动脉粥样硬化指数诊断代谢相关脂肪性肝病效能分析*

曹焱芬, 邹昊轩, 谢艳   

  1. 610000 成都市 四川大学华西医院消化内科
  • 收稿日期:2024-02-18 出版日期:2024-05-10 发布日期:2024-06-11
  • 通讯作者: 谢艳,E-mail:xieyan@wchscu.cn
  • 作者简介:曹焱芬,女,36岁,医学硕士,主治医师。研究方向:MAFLD防治研究。E-mail:15879261682@163.com
  • 基金资助:
    * 四川省卫生健康委员会科研课题(编号:20PJ180)

Diagnostic performance of atherogenic index of plasma in predicting patients with metabolic-associated fatty liver disease from physical examination population

Cao Yanfen, Zou Haoxuan, Xie Yan   

  1. Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
  • Received:2024-02-18 Online:2024-05-10 Published:2024-06-11

摘要: 目的 研究血浆致动脉粥样硬化指数(AIP)诊断代谢相关脂肪性肝病(MAFLD)患者的效能。方法 2020年7月~2022年12月四川大学华西医院健康管理中心接受体检的人群,常规检测血清指标,计算AIP。采用Logistic回归分析危险因素,应用受试者工作特征曲线(ROC)分析诊断效能。结果 在4988名体检人群中,发现MAFLD患者1589例(32.4%);MAFLD组血脂水平显著高于无MAFLD组,其中AIP为0.2(0.0~0.4),显著高于无MAFLD组【0.1(0.1~0.3),P<0.001】;多因素Logistic回归分析结果显示,AIP、TG、HDL、LDL和TC均为影响MAFLD患病的独立危险因素(P<0.05);ROC分析显示AIP诊断MAFLD的曲线下面积(AUC)为0.785,显著高于甘油三酯(0.764)、高密度脂蛋白(0.750)、低密度脂蛋白(0.568)或总胆固醇(0.552)诊断;采用DeLong检验,AIP诊断女性MAFLD 的AUC值显著高于诊断男性(0.817对0.714),AIP诊断<45岁人群MAFLD的 AUC值也显著高于诊断≥45岁人群(0.825对0.742,P<0.001)。 结论 应用AIP诊断MAFLD简单易行,可作为初步筛查方法用于判别脂肪肝人群,值得进一步验证。

关键词: 代谢相关脂肪性肝病, 血浆致动脉粥样硬化指数, 受试者工作特征曲线, 诊断

Abstract: Objective This study was conducted to investigate diagnostic performance of atherogenic index of plasma (AIP)in predicting patients with metabolic-associated fatty liver disease (MAFLD) from physical examination population. Methods 4988 individuals underwent physical examination in the Physical Examination Center, West China Hospital, affiliated to Sichuan University between July 2020 and December 2022. Routine blood fat was detected for calculation of AIP. Multivariate Logistic regression analysis was applied to reveal risk factors, and receiver operating characteristic curve (ROC) was used to assess diagnostic efficacy. Results Of 4988 individuals at physical examination, 1589 patients(32.4%)was found having MAFLD; hyperlipidemia was common in patients with MAFLD, and AIP was 0.2(0.0-0.4), much greater than [0.1(0.1-0.3), P<0.001] in those without MAFLD; multivariate Logistic regression analysis showed that AIP, TG, HDL, LDL and TC were all the independent risk factors for MAFLD existence (P<0.05); ROC analysis demonstrated the AUC was 0.785 by AIP predicting MAFLD, much higher than TG(0.764), HDL (0.750), LDL (0.568) OR TC (0.552) doing; the AUC was 0.817 by AIP in diagnosing female MAFLD, much higher than 0.714 in diagnosing male MAFLD, and it was 0.825 in predicting MAFLD in persons younger than 45 year old, much higher than 0.742 in predicting MAFLD in those older than 45 year old (P<0.001). Conclusion AIP has a satisfactory diagnostic performance in predicting MAFLD, which might be used for screening at physical examination centers.

Key words: Metabolic-associated fatty liver disease, Atherogenic index of plasma, Receiver operation characteristic curve, Diagnosis