总胆固醇、甘油三酯和胰岛素敏感指数对非酒精性脂肪肝诊断价值的比较

Comparison of the diagnostic value of total cholesterol,triglycerides and insulin sensitivity indexin non-alcoholic fatty liver disease

目的探讨总胆固醇(TC)、甘油三酯(TG)和胰岛素敏感指数(HOMA-IR)等3个指标对非酒精性脂肪肝(NAFLD)诊断价值。方法分析122例本院门诊及住院的患者总胆固醇、甘油三酯、空腹血糖、空腹胰岛素等指标,计算胰岛素敏感指数稳态模型评价(HOMA-IR),应用受试者工作特征曲线(ROC曲线),以最大约登指数确定切点,并将各分界点值作为诊断标准时所对应的灵敏度、特异度、准确率、约登指数、阳性似然比及阴性似然比。结果总胆固醇的切值为4.89,灵敏度为61.40%,特异度为73.10%;甘油三酯的切值为1.45,灵敏度为68.20%,特异度为67.90%;稳态模型评价HOMA-IR的切值为3.36,灵敏度为38.60%,特异度为83.30%。结论联合检测总胆固醇和甘油三酯可提高非酒精性脂肪肝的诊断效能。

Objective To discuss the diagnostic value of total cholesterol（ TC）, triglycerides（TG） and insulin sen- sitivity index in non - alcoholic fatty liver disease （NAFLD）. Methods One hundred and twenty - two cases of hospital outpatients and hospitalized patients were involved to detect the total cholesterol, triglycerides, fasting plas- ma glucose and fasting insulin, and calculate the homeostasis model assessment （HOMA） as the insulin sensitive in- dex. In addition, receiver operating characteristic curve （ROC curve） was used to determine the cut point. The op- timal cutoff values were determined by the maximal Youden＇ s index. And the cutoff point value was taken as a diag- nostic criterion of the corresponding sensitivity, specificity, accuracy, Youden＇ s index, positive likelihood ratio and negative likelihood ratio. Results TC＇ s cutoff value was 4.89, the sensitivity was 61.40%, the specificity was 73.10% ; TG＇ s cutoff value was 1.45, the sensitivity was 68.20%, the specificity was 67.90% ; HOMA - IR＇ s cutoff value is 3.36, the sensitivity is 38.60%, the specificity is 83.30%. Conclusion The combination of TC and TG can improve the diagnosis efficiency of non - alcoholic fatty liver disease.