内脏脂肪面积联合血脂预测2型糖尿病合并非酒精性脂肪性肝病价值分析*

doi:10.3969/j.issn.1672-5069.2026.01.013

摘要/Abstract

摘要： 目的分析内脏脂肪面积(VFA)联合血脂预测2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的价值。方法 2021年6月～2023年6月我院诊治的2型糖尿病(T2DM)合并NAFLD患者52例和T2DM患者48例,使用日本欧姆龙HDS-2000型内脏脂肪检测装置检测VFA,常规检测血脂水平和腰臀比(WHR),应用多因素二元Logistic回归分析影响因素,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估预测效能。结果 T2DM合并NAFLD组BMI、VFA、WHR、血清TG、TC和LDL-C水平分别为(26.4±3.1)kg/m²、(114.8±21.8)cm²、(1.0±0.1)、(2.9±1.1)mmol/L、(6.6±1.0)mmol/L和(4.2±0.9)mmol/L,均显著高于T2DM组【分别为(23.6±3.6)kg/m²、(88.2±19.5)cm²、(0.9±0.1)、(1.6±0.8)mmol/L、(4.7±0.9)mmol/L和(2.8±0.8)mmol/L,P＜0.05】,血清HDL-C水平为(0.9±0.5)mmol/L,显著低于T2DM组【(1.2±0.3)mmol/L,P＜0.05】;多因素二元Logistic回归分析显示BMI、VFA、WHR和血清TG、TC、LDL-C水平均为影响T2DM患者合并NAFLD的独立危险因素,而血清HDL-C为T2DM患者不合并NAFLD的保护因素;ROC曲线分析显示,联合VFA、WHR和血脂异常预测T2DM合并NAFLD的灵敏度为94.2%,特异度为77.1%,显著优于任一指标单独预测。结论联合VFA、WHR和血脂水平可以帮助临床医生初步筛选T2DM患者可能合并NAFLD,为进一步诊治提供依据。

关键词: 非酒精性脂肪性肝病, 2型糖尿病, 内脏脂肪面积, 腰臀比, 血脂, 诊断

Abstract: Objective The purpose of this study was to investigate prediction of concomitant nonalcoholic fatty liver disease (NAFLD) in patients with type two diabetes mellitus (T2DM) by visceral fat area (VFA) and blood lipid. Methods 52 patients with T2DM and concomitant NAFLD and 48 patients with T2DM were encountered in our hospital between June 2021 and June 2023, VFA was detected by Japanese made special visceral fat detection apparatus, and blood lipid and waist-to-hip ratio (WHR) were routinely determined. Multivariate Logistic regression analysis was applied to find impacting factors for NAFLD coexistence, and area under receiver operating characteristic curve (AUC) was used to verify predicting performance. Results BMI, VFA, WHR, serum triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels in patients with T2DM/NAFLD group were(26.4±3.1)kg/m²,(114.8±21.8)cm², (1.0±0.1), (2.9±1.1)mmol/L, (6.6±1.0)mmol/L and (4.2±0.9)mmol/L, all significantly higher than [(23.6±3.6)kg/m², (88.2±19.5)cm², (0.9±0.1), (1.6±0.8)mmol/L, (4.7±0.9)mmol/L and (2.8±0.8)mmol/L, respectively, P＜0.05], while serum high-density lipoprotein cholesterol (HDL-C) level was (0.9±0.5)mmol/L, significantly lower than [(1.2±0.3)mmol/L, P＜0.05] in T2DM group; multivariate Logistic regression analysis showed that BMI, VFA, WHR and serum TG, TC and LDL-C levels were all the independent risk factors for co-existence of NAFLD in patients with T2DM, and serum HDL-C level was the protective factor; ROC analysis demonstrated that combination of VFA, WHR and blood lipid were much superior to any parameter did in predicting co-existence of NAFLD, with sensitivity of 94.2% and specificity of 77.1%. Conclusion Combination of VFA, WHR and blood lipids in predicting concomitant NAFLD in patients with T2DM is efficacious, which might help clinicians make appropriately measures for further intervention.

Key words: Nonalcoholic fatty liver disease, Type 2 diabetes mellitus, Visceral fat area, Waist-to-hip ratio, Blood lipids, Diagnosis

李晓庆, 刘迎见, 曹辉, 朱玉峰. 内脏脂肪面积联合血脂预测2型糖尿病合并非酒精性脂肪性肝病价值分析^*[J]. 实用肝脏病杂志, 2026, 29(1): 49-52.

Li Xiaoqing, Liu Yingjian, Cao Hui, et al. Prediction of concomitant nonalcoholic fatty liver disease in patients with type two diabetes mellitus by visceral fat area and blood lipid[J]. Journal of Practical Hepatology, 2026, 29(1): 49-52.

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内脏脂肪面积联合血脂预测2型糖尿病合并非酒精性脂肪性肝病价值分析^*

Prediction of concomitant nonalcoholic fatty liver disease in patients with type two diabetes mellitus by visceral fat area and blood lipid

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