心脏代谢指数与非酒精性脂肪性肝病严重程度的相关性研究

Correlation between cardiometabolic index and the severity of non-alcoholic fatty liver disease

目的探讨心脏代谢指数(CMI)与非酒精性脂肪性肝病(NAFLD)严重程度的相关性及其预测价值,为早期筛查和防治NAFLD提供参考依据。方法选取2022年1-4月在新疆医科大学第一临床医学院参加健康检查的体检者536例,根据B型超声相关参数分为NAFLD组(n=272)和非NAFLD组(n=264),其中NAFLD组依据超声诊断NAFLD分级标准进一步分为轻度(n=137)、中度(n=94)和重度(n=41)3个亚组。收集所有研究对象的基本资料,以及空腹血糖、血尿酸、血脂等临床实验室指标检测结果。比较NAFLD组与非NAFLD组的CMI,并分析CMI与NAFLD严重程度的相关性及其预测价值。结果将研究对象以性别分层后,在男、女性人群中,NAFLD组CMI均高于非NAFLD组,差异有统计学意义(P<0.05)。男性重度NAFLD组CMI高于轻度NAFLD组,女性中度NAFLD组和重度NAFLD组CMI均高于轻度NAFLD组,差异有统计学意义(P<0.05)。Spearman相关系数显示,男性和女性CMI与NAFLD严重程度均呈正相关(r=0.222,P=0.004;r=0.445,P<0.001)。多元logistic回归分析结果显示,校正经常运动、体重指数、总胆固醇等混杂因素后,CMI与男、女性NAFLD严重程度独立相关,且女性轻度NAFLD组和中-重度NAFLD组CMI的OR值均高于男性,分别为3.880(95%CI:1.282~11.740)和15.078(95%CI:4.390~51.785)。受试者工作特征(ROC)曲线分析结果显示,CMI预测女性轻度和中-重度NAFLD的ROC曲线下面积(AUC)均高于男性,分别为0.806(95%CI:0.749~0.856)和0.912(95%CI:0.865~0.947)。结论CMI与NAFLD严重程度密切相关,且对女性人群NAFLD严重程度具有更高的预测价值。

Objective To investigate the relationship between the cardiometabolic index(CMI)and the severity of nonalcoholic fatty liver disease(NAFLD),as well as its predictive value,so as to provide a reference for early screening and prevention of NAFLD.Methods A total of 536 examinees who participated in health checkups in the First Clinical Medical College of Xinjiang Medical University from January to April 2022 were selected.According to B-mode ultrasound parameters,the participants were divided into two groups:the NAFLD group(n=272)and non-NAFLD group(n=264).The NAFLD group was further divided into three subgroups according to the NAFLD grading standard for ultrasound diagnosis:the mild group(n=137),moderate group(n=94),and severe group(n=41).The basic information of all research subjects,as well as the test results of clinical laboratory indicators such as fasting plasma glucose,blood uric acid,and blood lipids,were collected.The CMI were compared between the NAFLD group and non-NAFLD group,and the correlation between CMI and the severity of NAFLD,as well as the predictive value of CMI,were analyzed.Results After stratifying the research subjects by gender,it was found that the CMI of the NAFLD group was higher than that of the non-NAFLD group in both males and females,and the differences were statistically significant(P<0.05).The CMI of the severe NAFLD group was higher than that of the mild NAFLD group in males,and the CMI of the moderate and severe NAFLD groups was also higher than that of the mild NAFLD group in females,and the differences were statistically significant(P<0.05).The Spearman correlation coefficient showed that CMI was positively correlated with the severity of NAFLD in both males and females(r=0.222,P=0.004;r=0.445,P<0.001).The results of the multiple logistic regression analysis showed that,after adjusting for confounding factors such as regular exercise,body mass index,and total cholesterol,CMI was independently correlated with the severity of NAFLD in both males and females.The odds ratio(OR)of CMI in the mild and moderate-severe NAFLD groups were higher in females compared with males.Specifically,the OR was 3.880(95%CI:1.282-11.740)in the female mild NAFLD group and 15.078(95%CI:4.390-51.785)in the female moderate-severe NAFLD group.The results of receiver operating characteristic(ROC)curve analysis showed that the areas under the ROC curve(AUC)of CMI predicting mild and moderate-severe NAFLD in females were higher than those in males,which were 0.806(95%CI:0.749-0.856)and 0.912(95%CI:0.865-0.947),respectively.Conclusion CMI is closely related to the severity of NAFLD,and has a higher predictive value for NAFLD severity in females.