关键词: 非酒精性脂肪性肝病, 甘油三脂, 高密度脂蛋白胆固醇, 诊断

Abstract: Objective To investigate the diagnostic value of serum TG/HDL-C ratio in patients with nonalcoholic fatty liver disease（NAFLD）. Methods 120 patients with NAFLD diagnosed by B-ultrasound examination in our hospital between January 2012 and May 2015 and 120 healthy persons with normal examination results in the same period were included in this study. Serum ALT,AST,triacylglyceride （TG）,HDL-C,TG/HDL-C ratio,GGT and liver/spleen CT ratio were compared between the two groups. Then NAFLD patients were divided into mild,moderate and severe fatty liver groups according to the liver/spleen CT ratio. Pearson correlation analysis was performed to get the correlation between TG,TG/HDL-C ratio,GGT and the degree of fatty liver disease. The ROC curve was used to analyze the diagnostic value of serum TG/HDL-C ratio in these patients. Results Serum ALT,AST,TG,TG/HDL-C ratio and GGT level in patients with NAFLD were（39.9±4.3） U/L,（39.5±3.8） U/L,（2.4±0.4） mmol/L,（3.2±0.6）,and （60.7±4.5） U/L,all significantly higher than those in the controls [（20.6±3.2） U/L,（18.0±2.9） U/L,（1.1±0.3） mmol/L,（0.9±0.4）,and （27.0±3.5） U/L,respectively,P<0.05];serum HDL-C and liver/spleen CT ratio in NAFLD patients were （0.9±0.2） mmol/L and（0.6±0.2）,much lower than those in the controls [（1.2±0.3） mmol/L and（0.9±0.1）,respectively,P<0.05];serum ALT,AST,TG,TG/HDL-C ratio and GGT level in 20 patients with severe fatty liver were （52.2±4.3） U/L,（51.8±4.0） U/L,（3.4±0.4） mmol/L,（4.8±0.5） and （77.5±3.9） U/L,all significantly higher than those in 49 patients with moderate [（45.9±4.1） U/L,（46.1±3.8） U/L,（2.8±0.3） mmol/L,（3.5±0.3）,（65.9±3.7） U/L] or 51 patients with mild fatty liver [（29.4±3.5）U/L,（28.3±3.2） U/L,（1.7±0.3） mmol/L,（1.5±0.2） and（49.2±3.4）U/L,respectively,P<0.05];serum HDL-C level in patients with severe fatty liver was （0.7±0.2） mmol/L,not significantly different as compared with that in moderate [（0.8±0.2） mmol/L] or with in mild group[（1.1±0.2） mmol/L,P>0.05];the CT liver/spleen ratio in patients with severe fatty liver was（0.4±0.1）,much lower than that in patients with moderate（0.6±0.1） or in with mild fatty liver[（0.8±0.1）,P<0.05];Pearson correlation analysis showed that there were negative correlations between serum TG,TG/HDL-C ratio,GGT levels and CT liver/spleen ratio,and there were positive correlations between serum TG,TG/HDL-C ratio,GGT level and serum ALT and AST levels;ROC curve showed that the AUC of TG/HDL-C ratio was 0.783,and when the cut-off value was 1.41,the diagnosis of NAFLD might exist. Conclusion Serum TG/HDL-C ratio might be an alternative for diagnosis of NAFLD in clinical practice.

Key words: Nonalcoholic fatty liver disease, Triglycerides, High density lipoprotein cholesterol, Diagnosis