小而密低密度脂蛋白胆固醇在脂肪肝患者诊断中的价值

Role of dense low-density lipoprotein cholesterolsmall in evaluating fatty liver

目的探讨小而密低密度脂蛋白胆固醇(sdLDL-C)在脂肪肝诊断中的价值。方法选取2020年1月至2021年3月期间,脂肪肝患者220例作为研究组,选取同期体检健康者220例作为对照组。两组受检者均采集空腹静脉血,检测血脂学与肝功能相关指标水平,采用受试者工作特征(ROC)曲线评估sdLDL-C对脂肪肝的诊断价值。结果与对照组相比,研究组sdLDL-C、总胆汁酸(TBA)、甘胆酸(CG)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和γ-谷氨酰基转移酶(GGT)结果高于对照组,差异有统计学意义(P<0.01),高密度脂蛋白(HDL)表达水平低于对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,血脂sdLDL-C诊断脂肪肝的曲线下面积为0.91,最佳临界值0.62 mmol/L,灵敏度为88.60%,特异度为85.0%。AST、ALT、GGT、TBA、CG和HDL诊断脂肪肝的曲线下面积(AUC)分别为0.62、0.74、0.76、0.59、0.61、0.70。血脂sdLDL-C联合ALT、AST、GGT、TBA、CG和HDL联合检测诊断脂肪肝的AUC为0.931,灵敏度为87.7%,特异度为88.6%。结论sdLDL-C是一项灵敏高、特异度强的诊断指标,可作为评价脂肪肝的灵敏指标。

Objective To investigate the role of small and dense low-density lipoprotein cholesterol(sdLDL-C)in evaluating fatty liver.Methods A total of 220 healthy subjects were enrolled as healthy control group,and 220 fatty liver patients were enrolled as study group in our hospital from January 2020 to March 2021.The fasting venous blood of the two groups of subjects was collected,the serum was centrifuged to de-tect liver function tests and serological related indicators.Receiver operating characteristic(ROC)curve was used to evaluate the role of small and dense low-density lipoprotein cholesterol for the diagnosis of fatty liver.Results The dates of sdLDL-C,total bile acids(TBA),Glycocholic acid(CG),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and gamma-glutamyl transferase(GGT)which were significantly higher than those in the control group,the differences were statistically significant(P<0.01).The dates of high density lipoprotein(HDL)were significantly lower than those in the control group,the difference was statistically significant(P<0.05).ROC curve analysis of sdLDL-C showed that the areas under the curves(AUC)for the diagnosis of fatty liver was 0.91,the optimal Cut off values was 0.62 mmol/L,the sensitivities were 88.60%and 85.0%.The AUC of ALT,AST,GGT,TBA,CG and HDL were 0.62,0.74,0.76,0.59,0.61,0.70 respectively.The AUC of sdLDL-C combined ALT,AST,GGT,TBA,CGand HDL for the detection of fatty liver is 0.931,the sensitivity is 87.7%,and the specificity is 88.6%.Conclusion sdLDL-C was a sensitive and highly specific diagnostic index,which can be used as a sensitive indicator in evaluating fatty liver.