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在中国人群中,代谢相关脂肪性肝病及其亚组的最佳非侵入性预测指标:一项回顾性病例对照研究。

Optimum non-invasive predictive indicators for metabolic dysfunction-associated fatty liver disease and its subgroups in the Chinese population: A retrospective case-control study.

机构信息

Graduate School, Peking Union Medical College, Beijing, China.

Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Dec 1;13:1035418. doi: 10.3389/fendo.2022.1035418. eCollection 2022.

Abstract

OBJECTIVE

Metabolic dysfunction-associated fatty liver disease (MAFLD) affects 25% of the population without approved drug therapy. According to the latest consensus, MAFLD is divided into three subgroups based on different diagnostic modalities, including Obesity, Lean, and Type 2 diabetes mellitus (TDM) MAFLD subgroups. This study aimed to find out the optimum non-invasive metabolism-related indicators to respectively predict MAFLD and its subgroups.

DESIGN

1058 Chinese participants were enrolled in this study. Anthropometric measurements, laboratory data, and ultrasonography features were collected. 22 metabolism-related indexes were calculated, including fatty liver index (FLI), lipid accumulation product (LAP), waist circumference-triglyceride index (WTI), etc. Logistic regression analyzed the correlation between indexes and MAFLD. Receiver operating characteristics were conducted to compare predictive values among 22 indicators for screening the best indicators to predict MAFLD in different subgroups.

RESULTS

FLI was the best predictor with the maximum odds ratio (OR) values of overall MAFLD (OR: 6.712, 95%CI: 4.766-9.452, area under the curve (AUC): 0.879, 0.05) and TDM MAFLD subgroup (OR: 14.725, 95%CI: 3.712-58.420, AUC: 0.958, 0.05). LAP was the best predictor with the maximum OR value of Obesity MAFLD subgroup (OR: 2.689, 95%CI: 2.182-3.313, AUC: 0.796, 0.05). WTI was the best predictor with the maximum OR values of Lean MAFLD subgroup (OR: 3.512, 95%CI: 2.286-5.395, AUC: 0.920, 0.05).

CONCLUSION

The best predictors of overall MAFLD, Obesity, Lean, and TDM MAFLD subgroups were respectively FLI, LAP, WTI, and FLI.

摘要

目的

代谢相关脂肪性肝病(MAFLD)影响 25%的人群,而目前尚无获批的药物治疗方法。根据最新共识,MAFLD 可根据不同的诊断方式分为三个亚组,包括肥胖、非肥胖和 2 型糖尿病(T2DM)MAFLD 亚组。本研究旨在找出最佳的非侵入性代谢相关指标,分别预测 MAFLD 及其亚组。

设计

本研究纳入了 1058 名中国参与者。收集了人体测量学指标、实验室数据和超声特征。计算了 22 项代谢相关指标,包括脂肪肝指数(FLI)、脂-肝指数(LAP)、腰围-甘油三酯指数(WTI)等。采用逻辑回归分析指标与 MAFLD 的相关性。通过受试者工作特征曲线比较 22 项指标预测不同亚组 MAFLD 的最佳指标。

结果

FLI 是总体 MAFLD(比值比 [OR]:6.712,95%置信区间 [CI]:4.766-9.452,曲线下面积 [AUC]:0.879,P=0.05)和 T2DM MAFLD 亚组(OR:14.725,95%CI:3.712-58.420,AUC:0.958,P=0.05)的最佳预测指标,具有最大的优势比(OR)值。LAP 是肥胖 MAFLD 亚组(OR:2.689,95%CI:2.182-3.313,AUC:0.796,P=0.05)的最佳预测指标。WTI 是瘦 MAFLD 亚组(OR:3.512,95%CI:2.286-5.395,AUC:0.920,P=0.05)的最佳预测指标。

结论

总体 MAFLD、肥胖、瘦、T2DM MAFLD 亚组的最佳预测指标分别为 FLI、LAP、WTI 和 FLI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7356/9751395/b676fffda196/fendo-13-1035418-g001.jpg

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