医务人员群体甘油三酯葡萄糖指数及其联合体重指数与非酒精性脂肪肝的关联分析

Association of triglyceride glucose index and its combination with body mass index with non-alcoholic fatty liver disease among medical workers

目的探讨在医务人员群体中甘油三酯葡萄糖(TyG)指数及TyG指数联合体重指数(TyG-BMI)与非酒精性脂肪肝(NAFLD)的关联, 并探讨二者对NAFLD的诊断价值。方法该研究为横断面研究。纳入2022年1至12月于首都医科大学附属北京积水潭医院健康管理中心进行健康体检的本院在职职工。根据是否检出NAFLD, 分为NAFLD组和对照组。通过医院健康体检数据库收集入选者的一般临床资料, 包括年龄、性别、身高、体重、收缩压、舒张压、实验室检查指标、影像学检查结果, 以及现病史、既往史、长期用药史、饮酒史等。采用多因素logistic回归模型分析医务人员群体患有NAFLD的关联因素。采用受试者工作特征(ROC)曲线分析TyG指数和TyG-BMI对NAFLD的诊断价值。结果共入选医务人员1 642名, 年龄36.0(31.0, 44.0)岁, 男性394名(24.00%)。其中377名检出NAFLD(NAFLD组), 1 265名未检出NAFLD(对照组)。多因素logistic回归分析结果显示TyG指数与NAFLD呈独立正向关联(OR=3.534, 95%CI:2.383~5.243, P<0.001), TyG-BMI亦与NAFLD呈独立正向关联(OR=1.041, 95CI:1.033~1.048, P<0.001)。ROC曲线分析结果显示, 在总人群中, TyG-BMI的曲线下面积(AUC)为0.906(95%CI:0.890~0.922), 敏感度为85.7%, 特异度为81.6%, TyG指数的AUC为0.845(95%CI:0.823~0.867), 敏感度为69.8%, 特异度为84.1%;在女性医务人员中, TyG-BMI的AUC为0.911(95%CI:0.892~0.931), 大于男性医务人员的0.852(95%CI:0.815~0.890);在女性医务人员中, TyG指数的AUC为0.832(95%CI:0.801~0.863), 亦大于男性医务人员的0.804(95%CI:0.761~0.846)。结论 TyG指数、TyG-BMI与医务人员患NAFLD密切相关, 且二者均对NAFLD具有较好的诊断价值, 尤其在女性医务人员中, 二者中TyG-BMI的诊断效能更高。

Objective:To explore the association of triglyceride glucose(TyG)index and its combination with body mass index(TyG-BMI)with non-alcoholic fatty liver disease(NAFLD)among medical workers.Method:A total of 1642 medical workers in Beijing Jishuitan Hospital with the age of 36.0(31.0,44.0)years and 394 males(24.00%)underwent health check-up in the hospital from January to December 2022.Among them,NAFLD was diagnosed in 377 subjects(NAFLD group)and 1265 had no NAFLD(control group).The anthrometric and clinical data were collected,including age,gender,height,weight,systolic blood pressure,diastolic blood pressure,laboratory test indicators,imaging findings,current and past medical history,long-term medication history,alcohol consumption history,etc.The factors associated NAFLD were analyzed with multivariate logistic regression model,the diagnostic value of TyG index and TyG-BMI for NAFLD was evaluated with receiver operating characteristic(ROC)curve.Results:Multivariate logistic regression analysis showed that TyG index(OR=3.534,95%CI:2.383-5.243,P<0.001)and TyG-BMI(OR=1.041,95 CI:1.033-1.048,P<0.001)were independently correlated with NAFLD.ROC curve analysis showed that the area under the curve(AUC)of TyG-BMI in diagnosis of NAFLD was 0.906(95%CI:0.890-0.922),with a sensitivity and specificity of 85.7%and 81.6%,respectively;while the AUC of TyG index was 0.845(95%CI:0.823-0.867)with a sensitivity and specificity of 69.8%and 84.1%,respectively.The AUC of TyG-BMI in female medical workers(0.911,95%CI:0.892-0.931)was higher than that of male ones(0.852,95%CI:0.815-0.890);the AUC of TyG index of female medical workers(0.832,95%CI:0.801-0.863)was also higher than that in male ones(0.804,95%CI:0.761-0.846).Conclusion:The prevalence of NAFLD among medical worker is associated with the TyG and TyG-BMI,and TyG-BMI has higher diagnostic value for NAFLD,especially among female medical workers.