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Association between triglyceride glucose index and its related derivative index and metabolic associated fatty liver disease in the elderly men
- Medical Journal of Chinese People′s Liberation Army Vol. 48, Issue 11, Pages: 1344-1352(2023)
- 作者机构：
1.解放军总医院第二医学中心门诊部急诊医学科/国家老年疾病临床研究中心，北京 100853
2.解放军总医院第二医学中心消化内科/国家老年疾病临床医学研究中心，北京 100853
- 作者简介：
E-mail: zhuangyj1201@163.com
- 基金信息：
DOI：10.11855/j.issn.0577-7402.0544.2023.1012
CLC：
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康娟, 刘文徽, 常青, 等. 三酰甘油-葡萄糖指数及其衍生指数与老年男性代谢相关脂肪性肝病的相关性分析[J]. 解放军医学杂志, 2023, 48(11): 1344-1352.
Kang Juan,Liu Wen-Hui,Chang Qing,et al.Association between triglyceride glucose index and its related derivative index and metabolic associated fatty liver disease in the elderly men[J].Medical Journal of Chinese People′s Liberation Army,2023,48(11):1344-1352.
康娟, 刘文徽, 常青, 等. 三酰甘油-葡萄糖指数及其衍生指数与老年男性代谢相关脂肪性肝病的相关性分析[J]. 解放军医学杂志, 2023, 48(11): 1344-1352. DOI： 10.11855/j.issn.0577-7402.0544.2023.1012.
Kang Juan,Liu Wen-Hui,Chang Qing,et al.Association between triglyceride glucose index and its related derivative index and metabolic associated fatty liver disease in the elderly men[J].Medical Journal of Chinese People′s Liberation Army,2023,48(11):1344-1352. DOI： 10.11855/j.issn.0577-7402.0544.2023.1012.
摘要
目的,2,探讨三酰甘油-葡萄糖(TyG)指数及其衍生指数三酰甘油-葡萄糖-体重指数(TyG-BMI)与老年男性人群代谢相关脂肪性肝病(MAFLD)患病风险之间的相关性。,方法,2,选取2021年1－12月于解放军总医院第二医学中心门诊行年度体检的2290例老年男性，分为MAFLD组(,n,=1322)与非MAFLD组(,n,=968)。筛选MAFLD患病的混杂因素，采用多因素logistic回归分析TyG指数及TyG-BMI与MAFLD患病风险的相关性，并绘制受试者工作特征(ROC)曲线探讨其对老年男性MAFLD患病风险的预测价值。,结果,2,2290例体检者年龄(74.3±10.1)岁，体重指数(BMI)为(24.63±2.70) kg/m,2,。MAFLD组BMI、γ-谷氨酰氨基转移酶(γ-GT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(Scr)、促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT,3,)、吸烟、饮酒率，以及高血压、糖尿病、高尿酸血症、高甘油三酯(TG)血症、低高密度脂蛋白胆固醇(HDL-C)血症、甲状腺结节、胆系结石等的患病率明显高于非MAFLD组(,P,<,0.05)，年龄低于非MAFLD组(,P,=0.003)。调整混杂因素后，多因素logistic回归分析显示，按TyG指数四分位数分组的Q,2,组、Q,3,组、Q,4,组患MAFLD的风险分别是Q,1,组的1.667倍(95%CI 1.257~2.236，,P,<,0.001)、2.004倍(95%CI 1.482~2.710，,P,<,0.001)、5.420倍(95%CI 3.266~8.995，,P,<,0.001)；按TyG-BMI四分位数分组的Q,2,组、Q,3,组、Q,4,组患MAFLD的风险分别是Q,1,组的2.215倍(95%CI 1.549~3.167，,P,<,0.001)、2.809倍(95%CI 1.723~4.580，,P,<,0.001)、2.513倍(95%CI 1.253~5.040，,P,=0.009)。TyG指数及TyG-BMI预测老年男性MAFLD的ROC曲线下面积(AUC)分别为0.717(95%CI 0.696~0.738)、0.840(95%CI 0.823~0.856)，最佳截断值分别为8.63、205.20；在无高脂血症及糖尿病的老年男性中，TyG指数与TyG-BMI预测MAFLD的AUC分别为0.653(95%CI 0.622~0.684)、0.840(95%CI 0.818~0.862)，最佳截断值分别为8.42、202.66。TyG-BMI预测MAFLD的AUC、准确率、特异度、敏感度、阳性预测值、阴性预测值均高于TyG指数。,结论,2,TyG指数及TyG-BMI高水平状态与老年男性MAFLD患病风险升高相关。TyG指数及TyG-BMI对老年男性MAFLD患病均有一定的预测价值，而TyG-BMI较TyG指数的预测价值更优。
Abstract
Objective,2,To explore the association between triglyceride glucose (TyG) index and TyG-body mass index (TyG-BMI) and the prevalence of metabolic associated fatty liver disease (MAFLD) in the elderly men.,Methods,2,Totally 2290 elderly men were selected from January to December in 2021 in the Second Medical Center of Chinese PLA General Hospital, and divided into MAFLD group (,n,=1322) and non-MAFLD group (,n,=968). Multivariate logistic regression was used to analyze the association between TyG index, TyG-BMI and MAFLD. The receiver operating characteristic (ROC) curve was drawn to explore the predictive value of TyG index and TyG-BMI with MAFLD in the elderly men.,Results,2,Two thousand two hundred and ninety elderly men were (74.3±10.1) years old, and an average BMI of (24.63±2.70) kg/m,2,. BMI, γ‑glutamyl transaminase (γ‑GT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Scr), thyroid stimulating hormone (TSH), free triiodothyronine (FT,3,), the rate of smoking and drinking, and the prevalence of hypertension, diabetes, hyperuricemia, high triglyceride (TG), low high density lipoprotein cholesterol (HDL-C), hyperuricemia, thyroid nodules and cholelithiasis were all significantly higher in non-MAFLD group than those in MAFLD group (,P,<,0.05), while the age of MAFLD group was lower than that of non-MAFLD group (,P,=0.003). Multivariate logistic regression analysis showed that the risk of MAFLD in patients of TyG quartile groups Q,2, Q,3, Q,4, was 1.667 (95%CI 1.257-2.236,P,<,0.001), 2.004 (95%CI 1.482-2.710,P,<,0.001) and 5.420 (95%CI 3.266-8.995,P,<,0.001) times higher than that of TyG Q,1, respectively. The risk of MAFLD in patients of TyG-BMI Q,2, Q,3, Q,4, was 2.215 (95%CI 1.549-3.167,P,<,0.001), 2.809 (95%CI 1.723-4.580,P,<,0.001) and 2.513 (95%CI 1.253-5.040,P,=0.009) times higher than that of TyG-BMI Q,1, respectively. The ROC curve showed that areas under the curve (AUC) of MAFLD predicted by TyG index and TyG-BMI were 0.717 (95%CI 0.696-0.738) and 0.840 (95%CI 0.823-0.856), and the best cut-off values were 8.63 and 205.20, respectively. Moreover, the ROC curve showed that AUC of MAFLD in the elderly men without hyperlipidemia or diabetes predicted by TyG index and TyG-BMI were 0.653 (95%CI 0.622-0.684) and 0.840 (95%CI 0.818-0.862), and the best cut-off values were 8.42 and 202.66, respectively. In addition, AUC, accuracy, specificity, sensitivity, positive predictive value and negative predictive value predicted by TyG-BMI were higher than those by TyG index.,Conclusions,2,TyG index and TyG-BMI are significantly associated with MAFLD in the elderly men. Both TyG index and TyG-BMI have certain predictive value for the prevalence of MAFLD in the elderly men, and TyG-BMI may be better.
关键词
非酒精性脂肪性肝病三酰甘油葡萄糖体重指数ROC曲线
Keywords
non-alcoholic fatty liver diseasetriacylglycerolglucosebody mass indexreceiver operating characteristic curve
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