研究HDL、ALT、TG联合检测在评估非酒精性脂肪性肝病风险中价值

Combination of HDL,ALT and TG achieves a good performance in risk assessment of non-alcoholic fatty liver disease

目的研究高密度脂蛋白(high density lipoprotein,HDL)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、甘油三酯(triglyceride,TG)联合检测在评估非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)风险中的价值。方法本研究实施描述性的研究方案,选择2018年6月-2021年5月江苏省海安市人民医院收治的120例NAFLD患者和120例体检健康的成年人为研究对象,分为观察组和对照组。观察组中脂肪肝情况,45例为轻度,47例为中度,28例为重度,比较两组研究对象及脂肪肝严重程度不同患者之间的ALT、HDL、TG水平,研究HDL、ALT、TG联合检测对NAFLD风险评估中的价值。结果观察组患者HDL(t=7.204,P<0.001)显著低于对照组,ALT(t=15.577,P<0.001)、TG(t=18.771,P<0.001)水平显著高于对照组;观察组内不同严重程度患者的HDL(F=8.621,P<0.001)、ALT(F=9.666,P<0.001)、TG(F=7.585,P<0.001)水平比较,差异有统计学意义(P<0.05),观察组患者组间比较,患者的HDL由低至高分别是重度组、中度组以及轻度组,患者的TG、ALT水平由低至高分别是轻度组、中度组以及重度组;通过相关性分析,患者的疾病严重程度与HDL呈现负相关,与ALT、TG呈现正相关;NAFLD通过联合诊断的特异度较各个指标单独检测更高;对ROC曲线分析发现,当联合检测时血清HDL、ALT、TG水平的cut-off值分别为1.10 mmol/L、37.12 mmol/L及1.96 mmol/L时,联合检测的准确度(80.42%),灵敏度(79.17%)和特异度(81.67%)最高,ROC曲线面积最大。结论NAFLD采用HDL、ALT、TG联合检测,诊断特异度显著升高。

Objective To study the power of combination of High-density lipoprotein(HDL),Alanine aminotransferase(ALT),triglyceride(TG)n the risk assessment of non-alcoholic fatty liver disease.Methods In this study,120NAFLD patients and 120 healthy adults admitted to the Hospital of Haian,Jiangsu Province from June 2018 to May2021 were selected as the research objects,and they were divided into observation group and control group.In the observation group,fatty liver was mild in 45 cases,moderate in 47 cases,and severe in 28 cases.The levels of ALT,HDL,and TG of subjects in the two groups and patients with different severity of fatty liver were compared to study the value of HDL,ALT,and TG combined detection in the risk assessment of NAFLD.Results HDL(t=7.204,P<0.001)in observation group was significantly lower than control group,and ALT(t=15.577,P<0.001)and TG(t=18.771,P<0.001)levels were significantly higher than control group.There were significant differences in HDL(F=8.621,P<0.001),ALT(F=9.666,P<0.001)and TG(F=7.585,P<0.001)levels among the three groups.The comparisons between three obervation groups showed that the HDL levels of the patients in the severe group,moderate group and mild group were changed from low to high.The levels of TG and ALT in patients of the severe group,moderate group and mild group showed reversed trend.Through correlation analysis,the severity of disease was negatively correlated with HDL,and positively correlated with ALT and TG.The accuracy of nonalcoholic fatty liver by combined diagnosis was higher than that by each index alone.Finally,When the cut-off values of serum HDL,ALT and TG levels were 1.10 mmol/L,37.12mmol/L and 1.96 mmol/L,respectively,the combined detection had the highest accuracy,sensitivity and specificity,and the largest ROC curve area.Conclusion The specificity of non-alcoholic fatty liver disease was significantly increased by HDL,ALT and TG combined detection.