定量CT测量腹部脂肪分布和肝脏脂肪含量与非酒精性脂肪肝相关性

Correlation between abdominal fat distributionn and liver fat conten in patients with non-alcoholic fatty liver disease by QCT

目的探讨定量CT测量的腹部脂肪分布和肝脏脂肪含量与非酒精性脂肪肝(NAFL)的相关性。方法选取63例行定量CT(QCT)检查的NAFL患者为病例组,同期检查的63例非脂肪肝患者为对照组。测量两组患者的腹部脂肪分布情况及肝脏脂肪含量(FatQI%)。比较两组间的差异与相关性,利用受试者工作特征(ROC)曲线计算NAFL的诊断效能。结果病例组的FatQI%、SAA、VAA、SMA、TAA、V/S及V/T均显著高于对照组,而年龄差异无统计学意义(P>0.05);CTL/S值与肝脏脂肪含量呈高度相关(r=-0.776,P<0.001)、与SAA、VAA、SMA及TAA呈中度相关(r=-0.499、-0.593、-0.409和-0.639,P<0.001);VAA和FatQI%是NAFL的独立危险因素;通过ROC曲线显示,FatQI%的曲线下面积(AUC)为0.952(95%CI为0.919~0.985)。结论肝脏脂肪含量、SAA、VAA、SMA及TAA与NAFL有相关性,VAA和肝脏脂肪含量可预测和评估NAFL的指标之一,肝脏脂肪含量可作为NAFL影像诊断的参考指标。

Objective To explore the correlation between the characteristic of abdominal fat distributionn and liver fat content measured by quantitative CT of non-alcoholic fatty liver(NAFL).Methods A total of 126 subjects included non-alcoholic fatty liver(NAFL)(n=63)and healthy controls group(n=63).All the subjects underwent quantitative CT(QCT scanning)at the department of radiology of Shanghai Sixth People's Hospital from May to July 2020.Both groups were measured subcutaneous adipose area(SAA),visceral adipose area(VAA),the total adipose area(TAA)and skeletal muscle area(SMA),and calculated the ratio of VAA to SAA(V/S)and the ratio of VAA to TAA(V/T);Liver fat content was measured,denoted as Fat QI%.The differences and correlations of the above values between the two groups were compared,and the relationship between relevant indicators and NAFL was discussed by multivariate logistic regression analysis.The ROC curve was used to calculate the diagnostic effectiveness of NAFL.Results The liver fat content,SAA,VAA,SMA,TAA,V/S and V/T in the case group were significantly higher than those in the control group,but the age difference was not statistically significant(P>0.05);CTL/S values were negatively correlated with liver fat content,SAA,VAA,SMA and TAA(R=-0.776,-0.499,-0.593,-0.409 and-0.639,P<0.001),with no significant correlation with V/S or V/T(P>0.05);Multi-factor logistics regression analysis showed that VAA and liver fat content were independent risk factors for NAFL.The ROC curve showed that the area under the curve(AUC)of liver fat content was 0.952(95%CI 0.919~0.985).Conclusion Liver fat content,SAA,VAA,SMA and TAA are correlated with NAFL;VAA can predict the influence of NAFL on disease;liver fat content measured by quantitative CT can quantitatively reflect the degree of liver fat infiltration,and can be used as a reference indicator for imaging diagnosis of NAFL.