六种无创评分诊断2型糖尿病合并代谢相关脂肪性肝病患者效能比较*

doi:10.3969/j.issn.1672-5069.2025.03.012

摘要/Abstract

摘要： 目的探讨6种无创评分诊断2型糖尿病(T2DM)合并代谢相关脂肪性肝病(MAFLD)的效能。方法 2023年1月～2023年12月合肥市第三人民医院内分泌科诊治的T2DM患者282例,其中合并MAFLD患者158例。常规临床检测和检查,获得胰岛素抵抗代谢指数(METS-IR)、甘油三酯葡萄糖指数(TyG)、甘油三酯葡萄糖体质指数(TyG-BMI)、肝脏脂肪变性指数(HSI)、弗雷明汉脂肪变性指数(FSI)和浙江大学指数(ZJUI)。应用受试者工作特征曲线(ROC)评估6种无创评分的诊断效能。结果 T2DM合并MAFLD组6种无创评分均显著大于T2DM组(P<0.05);TyG-BMI诊断的AUC为0.857(95% CI:0.814～0.900),ZJU指数诊断的AUC为0.852(95% CI:0.808～0.896),具有较好的诊断效能。结论 TyG-BMI和ZJU指数诊断T2DM 患者发生MAFLD具有良好的临床应用价值。

Abstract: Objective The aim of this study was to evaluate diagnostic performance of six non-invasive evaluation scores for type 2 diabetes mellitus (T2DM) with metabolic associated fatty liver disease (MAFLD). Methods A total of 282 patients T2DM, of them MAFLD was diagnosed in 158 cases, were enrolled in our hospital between January and December 2023, and from conventional clinical materials, metabolic score for insulin resistance (METS-IR), triglyceride-glucose index(TyG), triglyceride glucose-body mass index (TyG-BMI), hepatic steatosis index (HSI), Framingham steatosis index (FSI) and Zhejiang University index (ZJUI) were calculated. The diagnostic efficacy of these scores was assessed by using receiver operating characteristic (ROC) curve analysis. Results All the six non-invasive evaluation scores were significantly greater in patients with T2DM and MAFLD than in those with T2DM (P<0.05); the predicting AUC by TyG-BMI was 0.857(95% CI:0.814-0.900), and the AUC by ZJUI was 0.852(95% CI:0.808-0.896), suggesting both having a satisfactory diagnostic performance. Conclusion Both TyG-BMI and ZJU index have an excellent predictive value for identifying MAFLD from patients with T2DM, offering potential tools for clinical screening and monitoring.

Key words: Metabolic dysfunction-associated fatty liver disease, Type 2 diabetes mellitus, Triglyceride glucose-body mass index, Zhejiang University index, Receiver operating characteristic curve, Diagnosis

秦浩, 方春华, 何競, 张磊, 冉斌, 汪丽萍, 张振华. 六种无创评分诊断2型糖尿病合并代谢相关脂肪性肝病患者效能比较^*[J]. 实用肝脏病杂志, 2025, 28(3): 366-369.

Qin Hao, Fang Chunhua, He Jing, et al. Comparison of diagnostic performance of six non-invasive evaluation scores for type 2 diabetes mellitus with metabolic associated fatty liver disease[J]. Journal of Practical Hepatology, 2025, 28(3): 366-369.

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六种无创评分诊断2型糖尿病合并代谢相关脂肪性肝病患者效能比较^*

Comparison of diagnostic performance of six non-invasive evaluation scores for type 2 diabetes mellitus with metabolic associated fatty liver disease

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