肥胖三指标与脂肪肝的关系研究

Three indexes of obesity in predicting fatty liver disease

目的研究腰围（WC）、腰身高比（WHtR）、BMI这三个肥胖指标与脂肪肝（FLD）的关系，为脂肪肝防治提供依据。方法对1113例参加健康体检者测量身高、体重、WC，并进行B超检查，分析男、女性WC、WHtR、BMI与FLD的关系。结果FLD检出率为171％，男性为207％，女性为7．5％，差异有统计学意义（P〈001）；WC、WHtR及13MI水平预测脂肪肝的ROC曲线下面积男性分别为0．878、0．860、0888，女性分别为0．852、0．845、0．912，95％可信限均有重迭，差异无统计学意义；WC、WHtR、BMI对FLD的阳性预测值（PV＋）男性分别为0576、0，508、O．535，女性分别为O．415、0．300、0．457，阴性预测值（PV-）男性分别为0918、0930、0．933，女性分别为0．977、0．970、0．974，危险程度（OR值）男性分别为15128、13．63、15．97，女性分别为30170、13．34、31．88。结论脂肪肝有较高的发病率，特别在男性已成为高发病；肥胖是脂肪肝的高危因素，WC、WHtR、BMI是非常有效的预测脂肪肝指标。

Objective To evaluate the application of obesity indexes waist circumference （WC）, waist-to-height ratio （WHtR）, body mass index （BMI） in predicting fatty liver disease （FLD）. Methods The height, weight, WC were measured and liv- er B-ultrasonic examination was performed in 1113 healthy check-up subjects. The value of WC, WHtR, BMI in predicting FLD was analyzed. Results The overall FLD rate was 17.1% in this group of subjects, and that for males was 20.7% and for females was 7.5%（P〈0.01）. The area under ROC curves of WC, WHtR and BMI in predicting FLD was 0.860,0.878 and 0.888, respectively for males and 0.852,0.845, 0.912 respectively for females; there was no significant difference between two genders. The positive predictive value （PV＋） of FLD with WC, WHtR, BMI was 0.576, 0.508, 0.535 respectively for males, and 0.415,0.300,0.457 respectively for females. The negative predictive value （PV-） was 0.918, 0.930, 0.933 respectively for males, and 0.977, 0.970, 0.974 respectively for females. The Odds ratio （OR） was 15.28, 13.63, 15.97 respectively for males, and 30.70, 13.34, 31.88 respectively for females. Conclusion Obesity is a risk factor of Fatty liver disease, the three indexes of obesity WC, WHtR and BMI can be used to predict FLD.