超声脂肪分数联合RC/HDL-C比值评估MAFLD患者肝脂肪变性程度价值研究*

doi:10.3969/j.issn.1672-5069.2026.04.009

摘要/Abstract

摘要： 目的探讨超声脂肪分数(UFF)联合残余胆固醇/高密度脂蛋白胆固醇(RC/HDL-C)比值评估代谢相关性脂肪性肝病(MAFLD)患者肝脂肪变性程度的价值。方法 2022年1月～2025年3月我院收治的MAFLD患者103例,均接受肝穿刺活检,采用彩色多普勒超声检测UFF值,常规行血生化指标检测,计算RC/HDL-C比值,应用Logistic回归分析影响MAFLD患者肝脂肪变性的因素,绘制受试者工作特征曲线(ROC)评估指标的诊断效能。结果在103例MAFLD患者中,组织病理学检查诊断肝脂肪变S1级41例,S2级38例和S3级24例;三组体质指数(BMI)存在显著性差异(P<0.05);S3级肝脂肪变性患者UFF和RC/HDL-C比值分别为(36.6±5.7)%和(1.0±0.3),均显著高于S2级患者【分别为(24.8±4.1)%和(0.7±0.2),P＜0.05】或S1级患者【分别为(15.7±3.3)%和(0.5±0.1),P＜0.05】;多因素Logistic回归分析显示,UFF(OR=2.694,95%CI:1.473～4.927)和RC/HDL-C比值(OR=2.115,95%CI:1.415～3.161)均是≥S2级肝脂肪变性发生的独立危险因素;应用UFF联合RC/HDL-C比值诊断S2/S3级肝脂肪变性的曲线下面积为0.863,其灵敏度为87.1%,特异度为70.7%。结论应用UFF联合RC/HDL-C比值可帮助临床医生初步排查显著的肝脂肪变性患者,为进一步诊治提供依据。

Abstract: Objective The aim of this study was to investigate evaluation of hepatic steatosis by ultrasound-derived fat fraction (UFF) in combination with remnant cholesterol/high-density lipoprotein cholesterol (RC/HDL-C) ratio in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Methods A total of 103 patients with MAFLD were admitted to our hospital between January 2022 and March 2025, and all underwent liver biopsy. UFF was detected by color Doppler ultrasound, and blood biochemical parameter were detected and RC/HDL-C ratio was calculated. Factors impacting severity of hepatic steatosis in MAFLD patients was analyzed by multivariate Logistic regression analysis, and diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curves. Results Of the 103 patients with MAFLD, liver histopathological examination found liver steatosis S1 in 41 cases, S2 in 38 cases and S3 in 24 cases; there was a significant difference as respect to body mass index among the three groups (P<0.05); UFF and RC/HDL-C ratio in patients with S3 liver steatosis were (36.6±5.7)% and (1.0±0.3), both significantly higher than [(24.8±4.1)% and (0.7±0.2), respectively, P＜0.05] in those with S2 or [(15.7±3.3)% and (0.5±0.1), respectively, P＜0.05] in those with S1; multivariate Logistic regression analysis showed that UFF(OR=2.694,95%CI:1.473-4.927) and RC/HDL-C ratio (OR=2.115,95%CI:1.415-3.161) were both independent impacting factors for ≥S2 liver steatosis; the AUC was 0.863, with sensitivity of 87.1% and specificity of 70.7%, when UFF in combination with RC/HDL-C ratio was set in predicting S2/S3 liver steatosis. Conclusion Diagnostic performance of combination of UFF and RC/HDL-C ratio is satisfactory in predicting severe liver steatosis in patients with MAFLD, which might help clinicians make further intervention steps.

Key words: Metabolic dysfunction-associated fatty liver disease, Ultrasound-derived fat fraction, Remnant cholesterol/high-density lipoprotein cholesterol ratio, Diagnosis

刘莹, 马小宏, 孙长江, 陈爱莲. 超声脂肪分数联合RC/HDL-C比值评估MAFLD患者肝脂肪变性程度价值研究^*[J]. 实用肝脏病杂志, 2026, 29(4): 513-516.

Liu Ying, Ma Xiaohong, Sun Changjiang, et al. Evaluation of hepatic steatosis by ultrasound-derived fat fraction in combination with RC/HDL-C ratio in patients with MAFLD[J]. Journal of Practical Hepatology, 2026, 29(4): 513-516.

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超声脂肪分数联合RC/HDL-C比值评估MAFLD患者肝脂肪变性程度价值研究^*

Evaluation of hepatic steatosis by ultrasound-derived fat fraction in combination with RC/HDL-C ratio in patients with MAFLD

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