脂质蓄积指数对非酒精性脂肪性肝病合并代谢综合征的预测价值

The Predictive Value of Lipid Accumulation Index for Non-alcoholic Fatty Liver Disease with Metabolic Syndrome

目的探讨脂质蓄积指数(LAP)对非酒精性脂肪性肝疾病(NAFLD)合并代谢综合征(MS)的预测价值。方法选取2018年12月~2019年8月重庆医科大学附属第一医院健康体检部健康体检的NAFLD患者1150例设为NAFLD组,另选取同期健康体检者1150例设为对照组;比较两组人体测量学及血液学指标水平,采用受试者工作特征曲线(ROC)评估LAP预测NAFLD合并MS的价值。结果NAFLD组BMI、腰围、收缩压、舒张压、FPG、ALT、AST、GGT、TC、TG、HDL-C、LDL-C均高于对照组,差异有统计学意义(P<0.05);两组年龄、ALP比较,差异无统计学意义(P>0.05);NAFLD组与代谢综合征相关的各组分超标发生率均高于对照组,差异有统计学意义(P<0.05);ROC曲线显示,LAP预测NAFLD合并MS的曲线下面积为0.806(95%CI:0.779~0.833),其诊断最佳界值为83.27,敏感度为86.21%,特异度为79.35%,约登指数为0.66。结论LAP可用于预测NAFLD合并MS,可对人群健康初步评估,且其测量方法简便、易行,适合于大规模筛查,可在基层医院进一步推广。

Objective To explore the predictive value of lipid accumulation index(LAP)for non-alcoholic fatty liver disease(NAFLD)combined with metabolic syndrome(MS).Methods 1150 cases of NAFLD patients undergoing physical examinations from the Health Examination Department of the First Affiliated Hospital of Chongqing Medical University from December 2018 to August 2019 were selected as the NAFLD group,and 1150 cases of healthy physical examination patients during the same period were selected as the control group;the two groups were compared.The level of measurement and hematology indicators,the receiver operating characteristic curve(ROC)was used to evaluate the value of LAP in predicting NAFLD with MS.Results BMI,waist circumference,systolic blood pressure,diastolic blood pressure,FPG,ALT,AST,GGT,TC,TG,HDL-C and LDL-C in the NAFLD group were all higher than those in the control group,the difference was statistically significant(P<0.05);Compared with age and ALP,the difference was not statistically significant(P>0.05);the incidence rate of each component related to metabolic syndrome in the NAFLD group was higher than that in the control group,the difference was statistically significant(P<0.05);ROC curve showed,LAP predicts that the area under the curve of NAFLD combined with MS was 0.806(95%CI:0.779~0.833),the best diagnostic cutoff was 83.27,the sensitivity was 86.21%,the specificity was 79.35%,and the Youden index was 0.66.Conclusion LAP could be used to predict NAFLD combined with MS,and could be used for preliminary assessment of population health,and its measurement method was simple and easy to implement,suitable for large-scale screening,and could be further promoted in primary hospitals.