体检人群血清脂联素水平与非酒精性脂肪肝病的关系研究

Relationship between serum adiponectin level and nonalcoholic fatty liver disease in physical examination population

目的探究体检人群血清脂联素水平与非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)的相关性,为临床NAFLD的预测及干预提供参考依据。方法将2021年1月—2022年12月达州市达川区人民医院(达州市第三人民医院)430例体检者纳入研究,所有研究对象均收集一般资料、行腹部超声检查及血生化指标检测[空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)、脂联素、谷草转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)]。Pearson相关分析探究血清脂联素与各临床参数及NAFLD相关性;绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价血清脂联素对NAFLD的预测价值;采用多因素logistic回归分析探究影响NAFLD发生危险因素。结果共检出NAFLD者107例(NAFLD组)、非NAFLD者323例(对照组);NAFLD组男性所占比例、体重指数、腰臀比、收缩压、FPG、FINS、HbAlc、HOMA-IR、TC、TG、LDL、AST、ALT均高于对照组(P<0.05),血清脂联素水平低于对照组(P<0.05);Pearson相关性分析显示,血清脂联素与体重指数、腰臀比、FPG、FINS、HbAlc、HOMA-IR、TG、LDL呈负相关(P<0.05);脂联素预测NAFLD发生的ROC曲线下面积为0.680(P<0.05);多因素logistic回归分析显示,脂联素降低是NAFLD发生的独立危险因素(OR=2.236,95%CI:1.262~4.287,P<0.05)。结论血清脂联素与NAFLD发生密切相关,检测其水平对NAFLD发生有较好的预测价值,临床可将其列为体检者的常规检查,以帮助临床预测NAFLD的发生并进行早期干预。

Objective To explore the correlation between serum adiponectin level and nonalcoholic fatty liver disease(NAFLD)amongst physical examination population so as to provide a reference basis for predicting and intervening NAFLD in clinical practice.Methods Four hundred and thirty subjects undergoing physical examination in Dazhou Dachuan District People’s Hospital(Dazhou Third People’s Hospital)from January 2021 to December 2022 were enrolled into this study.All the subjects’general data were collected,and then they underwent abdominal ultrasound examination and detection of blood biochemical indicators(including fasting plasma glucose(FPG),fasting insulin(FINS),glycosylated hemoglobin(HbAlc),homeostasis model assessment of insulin resistance(HOMA-IR),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),adiponectin,aspartate aminotransferase(AST)and alanine aminotransferase(ALT)).Pearson correlation analysis was performed to explore the correlations of serum adiponectin with each clinical parameter and NAFLD.Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum adiponectin on NAFLD,and multivariate logistic regression analysis was used to explore the risk factors affecting NAFLD occurrence.Results A total of 107 patients with NAFLD(the NAFLD group)and 323 subjects without NAFLD(the control group)were detected.The male ratio,body mass index(BMI),waist-to-hip ratio,systolic blood pressure,FPG,FINS,HbAlc,HOMA-IR,TC,TG,LDL,AST and ALT were all significantly higher in the NAFLD group than in the control group(all P<0.05),while serum adiponectin level was significantly lower in the NAFLD group than in the control group(P<0.05).Pearson correlation analysis revealed that serum adiponectin was negatively correlated with BMI,waist-to-hip ratio,FPG,FINS,HbAlc,HOMA-IR,TG and LDL(P<0.05).The area under the ROC curve of adiponectin in predicting NAFLD was 0.680(P<0.05).Multivariate logistic regression analysis displayed that reduced adiponectin was an independent risk factor for NAFLD occurrence(OR=2.236,95%CI:1.262-4.287,P<0.05).Conclusion Serum adiponectin is closely related to NAFLD occurrence,and detecting its level has a good value in predicting NAFLD occurrence.It can be classified as a routine examination for physical examinees so as to help clinically predict NAFLD occurrence and perform early intervention.