健康体检成人FibroScan检测肝脏硬度值与受控衰减参数的相关分析*

doi:10.3969/j.issn.1672-5069.2014.05.010

实用肝脏病杂志 ›› 2014, Vol. 17 ›› Issue (5): 484-489.doi: 10.3969/j.issn.1672-5069.2014.05.010

健康体检成人FibroScan检测肝脏硬度值与受控衰减参数的相关分析^*

卢加发, 刘文斌, 潘勤, 陈光榆, 沈峰, 章瑞南, 朱婵艳, 陈一铭, 张舒宜, 吴佳瑜, 范建高

200092 上海市上海交通大学医学院附属新华医院消化内科（卢加发,潘勤,沈峰,章瑞南,朱婵艳,陈一铭,张舒宜,吴佳愉,范建高）; 临床流行病学研究中心（陈光榆）; 上海市五角场社区卫生服务中心（刘文斌）

收稿日期:2014-04-26 出版日期:2014-10-31 发布日期:2016-04-11
作者简介:卢加发,男,30岁,硕士研究生,医师。主要从事脂肪肝防治研究。E-mail：lujia120@hotmail.com
基金资助:
国家重点基础研究发展计划（973计划）项目（2012CB517501）; 中国肝炎防治基金会王宝恩肝纤维化研究基金资助（XJS20120501）; 上海交通大学医学院附属新华医院院长基金（12QYJ05）

A correlation of liver stiffness to controlled attenuation parameter in healthy individuals

Lu Jiafa, Liu Wenbin, Pan Qin

Department of Gastroenterology,Xinhua Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200092,China

Received:2014-04-26 Online:2014-10-31 Published:2016-04-11

摘要/Abstract

摘要： 目的探讨普通人群肝脏硬度测量值（LSM）与受控衰减参数（CAP）之间的关联,为临床研究提供参考。方法在207例成功进行FibroScan检查的健康体检者,获取性别、年龄、体质量指数（BMI）和腰高比（WHtR）资料,分析其LSM和CAP的相关性。结果不同年龄人群LSM的差异无统计学意义,但在BMI≥24 kg/㎡的受试者,其LSM和CAP值分别为（4.60±1.15） kPa和（245.24±55.37） dB/m,均显著高于BMI<24 kg/㎡的受试者[（4.25±1.23） kPa和（215.82±55.47） dB/m,P<0.001];WHtR≥0.50的受试者LSM和CAP分别为（4.52±1.22） kPa和（247.04±57.78）dB/m,亦均高于WHtR<0.50的受试者[(4.19±1.15） kPa和（204.65±52.25） dB/m,P<0.05];男性受试者LSM和CAP值亦均高于女性受试者[（4.53±1.23） kPa和（4.11±1.08） dB/m对（4.11±1.08） kPa和（220.08±57.88） dB/m,P<0.05];年龄≥50岁的受试者CAP值[（246.56±59.06） dB/m]高于年龄<50岁的受试者[（222.88±56.60） dB/m];LSM与CAP值呈显著性正相关（r=0.26,P=0.0002）;进一步对各组人群分析发现,在BMI≥24 kg/㎡、WHtR>0.50、男性受试者和年龄≥50岁的受试者中,LSM与CAP值呈显著性正相关（P<0.05）,其中在BMI≥24 kg/㎡组人群,两者呈非常显著性正相关（r=0.37,P<0.01）;通过相关分析发现,LSM和CAP均与BMI、WHtR和性别相关（P<0.05）;通过偏相关分析发现,LSM与CAP参数之间呈显著性正相关（r=0.20,P=0.0045）;在体质量指数≥24 kg/㎡的超重或肥胖的受试者中,肝脏硬度值和受控衰减参数的相关性更强（r=0.37,P=0.0003）。结论普通人群LSM与CAP均受BMI、WHtR和性别的影响,并且两个参数之间表现出一定的正相关,其相关存在的确切原因有待于进一步研究。

关键词: 肝脏硬度测量值, 受控衰减参数, 瞬时弹性成像技术, 体检

Abstract: Objective To explore the correlation between liver stiffness measurement （LSM） and controlled attenuation parameter （CAP） in the general population. Methods A correlation of LSM to CAP was conducted in a total of 207 participants who were successfully examined by FibroScan in a general health examination,and the data including gender,age,body mass index（BMI） and waist height radio （WHtR） were recorded. Results The LSM and CAP in overweight and obese participants （BMI≥24 kg/m²） were higher than those in lean participants （BMI<24 kg/m²） [（4.60±1.15）kPa vs. （4.25±1.23）kPa,P<0.001 and （245.24±55.37） dB/m vs.（215.82±55.47） dB/m,P<0.001];participants with WHtR≥0.50 had higher LSM and CAP as compared to those with WHtR<0.50 [（4.52±1.22） kPa vs.（4.19±1.15） kPa,P<0.05 and（247.04±57.78） dB/m vs.（204.65±52.25） dB/m,P<0.05];male participants had higher LSM and CAP than in female [（4.53±1.23）kPa vs.（4.11±1.08） kPa,P<0.05 and （4.11±1.08） dB/m vs.（220.08±57.88） dB/m,P<0.05]; the CAP was higher in participants older than 50 years as compared to participants under 50 years[（246.56±59.06）dB/m vs.（222.88±56.60） dB/m,P<0.01],while the LSM in the two groups showed no difference（P>0.05）;The LSM was significantly correlated with CAP in this cohort（r=0.26,P=0.0002）;Further analysis demonstrated that CAP was correlated with LSM in male,older than or equal to 50 years,

卢加发, 刘文斌, 潘勤, 陈光榆, 沈峰, 章瑞南, 朱婵艳, 陈一铭, 张舒宜, 吴佳瑜, 范建高. 健康体检成人FibroScan检测肝脏硬度值与受控衰减参数的相关分析^*[J]. 实用肝脏病杂志, 2014, 17(5): 484-489.

Lu Jiafa, Liu Wenbin, Pan Qin. A correlation of liver stiffness to controlled attenuation parameter in healthy individuals[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(5): 484-489.

参考文献

[1] Foucher J,Chanteloup E,Vergniol J,et al. Diagnosis of cirrhosis by transient elastography （FibroScan）:a prospective study. Gut,2006,55（3）:403-408.
[2] Andersen ES,Christensen PB,Weis N.Transient elastography for liver fibrosis diagnosis.Eur J Intern Med,2009,20（4）:339-342.
[3] Sasso M,Beaugrand M,de Ledinghen V,et al. Controlled attenuation parameter （CAP）:a novel VCTE guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol,2010,36（11）:1825-1835.
[4] Wong GLH. Transient elastography:Kill two birds with one stone. World J Hepatol,2013,5（5）:264-274.
[5] Sasso M,Tengher-Barna I,Ziol M,et al. Novel controlled attenuation parameter for noninvasive assessment of steatosis using Fibroscan:validation in chronic hepatitis. C. J Viral Hepat,2012,19（4）:244-253.
[6] Sasso M,Miette V,Sandrin L,et al. The controlled attenuation parameter（CAP）:A novel tool for the non-invasive evaluation of steatosis using Fibroscan. Clin Res Hepatol Gastroenterol,2012,36（1）:13-20.
[7] Roulot D,Czernichow S,Beaugrand M et al. Liver stiffness values in apparently healthy subjects:influence of gender and metabolic syndrome. J Hepatol,2008,48（4）:606-613.
[8] Kumar M,Rastogi A,Singh A,et al. Controlled attenuation parameter for non-invasive assessment of hepatic steatosis:Does etiology affect performance J Gastroenterol Hepatol,2013,28（7）:1194-1201.
[9] Chon YE,Jung KS,Kim SU,et al. Controlled attenuation parameter（CAP） for detection of hepatic steatosis in patients with chronic liver diseases:a prospective study of a native Korean population. Liver Int,2013,34（1）:102-109.
[10] de Ledinghen V,Vergniol J,Foucher J,et al. Non-invasive diagnosis of liver steatosis using controlled attenuation parameter （CAP） and transient elastography. Liver Int,2012,32（6）:911-918.
[11] Myers RP,Pollett A,Kirsch R,et al. Controlled attenuation parameter（CAP）:a noninvasive method for the detection of hepatic steatosis based on transient elastography. Liver Int,2012,32（6）:902-910.
[12] Carvalhana S,Leitao J,Alves AC,et al. How good is controlled attenuation parameter and fatty liver index for assessing liver steatosis in general population:correlation with ultrasound. Liver Int,2013 Aug 12. doi:10.1111/liv.12305. [Epub ahead of print]
[13] 中华人民共和国卫生部疾病控制司. 中国成人超重和肥胖症预防控制指南. 北京:人民卫生出版社,2006,1-4.
[14] 彭亚光,李莹,郭敏,等. 腰围身高比值评价严重中心性肥胖及体质量过低的适宜切点. 中华心血管病杂志,2013,14（7）:607-610.
[15] Andersen ES,Christensen PB,Weis N. Transient elastography for liver fibrosis diagnosis. Eur J Intern Med,2009,20（4）:339-342.
[16] Ling WW,Lu Q,Quan,JR,et al. Assessment of impact factors on shear wave based liver stiffness measurement. Eur J Radiol, 2013,82（2）:335-341.
[17] Hsieh SD,Yoshinaga H. Abdominal fat distribution and coronary heart disease risk factors in men-waist/height ratio as a simple and useful predictor.Int J Obes Relat Metab Disord,1995,19（8）:585-589.
[18] Ashwell M,Gunn P,Gibson S.Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors：systematic review and meta-analysis. Obes Rev,2012,13（3）:275-286.
[19] 赵连成, 李莹, 彭亚光, 等. 我国成人中心性肥胖腰围身高比值的适宜切点的研究.中国预防医学杂志,2012,13（7）:48l-485.
[20] He Y,Zhai F,Ma G,et a1. Abdominal obesity and the prevalence of diabetes and intermediate hyperglycaemia in Chinese adults.Public Health Nutr,2009,12（8）:1078-1084.
[21] 范建高,周琪,沃千红. 人体质量指数及其变化与非酒精性脂肪性肝病发病的关系. 中华肝脏病杂志,2010,18（9）:676-682.
[22] Shen F,Zheng RD,Mi YQ,et al. Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients. World J Gastroenterol,2014,20（16）:4702-4711.

健康体检成人FibroScan检测肝脏硬度值与受控衰减参数的相关分析^*

A correlation of liver stiffness to controlled attenuation parameter in healthy individuals

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