我国中老年人群脂肪肝指数与胰岛素抵抗的相关性研究

Study of correlation between fatty liver index and insulin resistance in middle-aged and elderly population in China

目的探讨我国中老年人群脂肪肝指数(FLI)与胰岛素抵抗(IR)的相关性。方法纳入南京市鼓楼区45岁以上社区自然人群3592例,根据胰岛素抵抗指数(HOMA-IR)分为IR组1938例和无IR组1654例;根据FLI分为FLI<30组2221例、30≤FLI<60组911例、FLI≥60组460例,比较不同亚组的一般资料、生化指标、血糖及胰岛素相关指标。采用Spearman非参数相关性分析评估FLI与HOMA-IR及胰岛β细胞功能相关指标的相关性;采用受试者工作特征(ROC)曲线评估FLI对IR的预判能力;采用多因素logistic回归分析评估FLI与IR的关系。结果 IR组男性比例、年龄、血压、血脂、肝功能、OGTT各时间点血糖和胰岛素、FLI、胰岛β细胞功能指数(HOMA-β)、早期胰岛素分泌指数(ΔI0-30/ΔG0-30)及HOMA-IR均高于无IR组,血肌酐和Matsuda ISI 均低于无IR组(P<0.05或P<0.001)。不同FLI亚组血压、生化指标、血糖及胰岛素相关指标比较差异均有统计学意义(P<0.001)。Spearman非参数相关分析结果显示,FLI与HONA-IR呈正相关(P<0.001),与Matsuda ISI呈负相关(P<0.001)。ROC曲线分析结果显示,依据FLI判断IR的ROC曲线下面积(AUC)为0.670(95%CI 0.653~0.688)。多因素logistic回归分析结果显示,FLI为IR的危险因素之一,可使IR的发生风险增加1.021倍(P<0.001)。结论在我国中老年人群中,FLI与IR相关,FLI可作为评估IR的简单易行的指标。

Objective To explore the correlation between fatty liver index(FLI) and insulin resistance(IR) in middle aged and elderly population in China.Methods A total of 3 592 community population aged over 45 years in Gulou district,Nanjing city were enrolled.The subjects were divided into IR group(1 938 cases) and non-IR group(1 654 cases) according to Homeostatic model assessment of insulin resistance index(HOMA-IR) and divided into FLI<30 group(2 221 cases),30≤FLI<60 group(911 cases) and FLI≥60 group(460 cases) based on FLI.General data,biochemical indexes,blood glucose and insulin related indexes of different subgroups were compared.Spearman nonparametric correlation analysis was used to evaluate the correlation between FLI and HOMA-IR,related indicators of islet β cell function.Receiver operating characteristic(ROC) curve was used to analyze the predictive value of FLI for IR.Multivariate logistic regression analysis was conducted to assess the relationship between FLI and IR.Results The rate of male population,age,blood pressure,blood fat,liver function,plasma glucose and insulin at each time point of OGTT,FLI,homeostatic model assessment of islet β cell function(HOMA-β),ΔI0-30/ΔG0-30 and HOMA-IR of IR group were higher than those of non-IR group,while serum creatinine and Matsuda ISI were lower than those of non-IR group(P<0.001).The differences of blood pressure,biochemical indexes,plasma glucose and insulin related indexes among different FLI subgroups were statistically significant(P<0.001).Spearman nonparametric correlation analysis results showed that FLI was positively correlated with HOMA-IR(P<0.001) and negatively correlated with Matsuda ISI(P<0.001).ROC curve analysis results showed that AUC of IR based on FLI was 0.670(95% CI 0.653-0.688).Multivariate logistic regression analysis results showed that FLI was one of the risk factors for IR and could increase the risk of IR by 1.021 times(P<0.001).Conclusion FLI is correlated with IR and can be a simple and practical index for evaluating IR in middle-aged and elderly population in China.