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| 内脏脂肪面积预测非酒精性脂肪性肝病患者严重程度的价值 |
| Analysis of value of visceral fat area in predicting severity of patients with nonalcoholic fatty liver disease |
| 投稿时间：2022-08-30 |
| DOI：10.3969/j.issn.1000-0399.2023.04.008 |
| 中文关键词: 非酒精性脂肪性肝病 内脏脂肪面积 非酒精性脂肪性肝病纤维化评分 |
| 英文关键词: Non-alcoholic fatty liver disease Visceral fat area NAFLD fibrosis score |
| 基金项目:江苏省自然科学基金面上项目（编号：BK20181235）；江苏省中医院科技项目（编号：Y2018CX09） |
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| 中文摘要: |
| 目的 分析非酒精性脂肪性肝病（NAFLD）患者内脏脂肪面积的变化，探讨内脏脂肪面积预测NAFLD患者严重程度的临床价值。方法 回顾性分析2019年10月至2021年10月在南京中医药大学附属医院就诊的198例NAFLD患者的临床资料。通过磁共振质子密度脂肪分数判断肝脏脂肪变性程度，其中轻度60例、中度52例、重度36例。选自同期50例健康体检者作为对照组。通过Sperman相关分析评价肝功能、血脂、NAFLD纤维化评分（NFS）与内脏脂肪面积的关系，创建内脏脂肪面积和NFS受试者工作特征（ROC）曲线，探讨内脏脂肪面积预测NAFLD患者严重程度的评估效能。结果 NAFLD患者的内脏脂肪面积高于对照组（F=43.413，P< 0.05），与疾病严重程度成正比。相关性分析结果显示，NAFLD患者内脏脂肪面积与NFS（r=0.293，P< 0.05）、肝脂肪变程度（r=0.697，P< 0.05）等呈正相关，与年龄、身体质量指数无明显相关性。ROC曲线分析结果显示，内脏脂肪面积预测轻、中、重度NAFLD患者的曲线下面积分别为0.870、0.867和0.835，对应的最佳截断点分别为80 cm2、95 cm2和105.95 cm2。内脏脂肪面积预测轻、中度NAFLD效能优于NFS（Z=3.987，P< 0.001；Z=2.253，P=0.024）；NFS预测重度NAFLD效能优于内脏脂肪面积（Z=2.274，P=0.023）。结论 NAFLD患者内脏脂肪面积水平明显升高，可作为辅助诊断轻、中度NAFLD的潜在指标。 |
| 英文摘要: |
| Objective To analyze the changes of visceral fat area in patients with nonalcoholic fatty liver disease (NAFLD) and to investigate the thermal value of visceral fat area in foreseeing the severity of patients with NAFLD. Methods The clinical data of 198 patients with NAFLD attending the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from October 2019 to October 2021 were retrospectively analyzed. The degree of hepatic steatosis was determined by magnetic resonance proton density fat fraction, of which 60 cases were in mild, 52 cases were moderate and 36 cases were in severe condition. The control group was selected from 50 healthy physical examination patients in the same period. The relationship between liver function, blood lipids, NAFLD fibrosis score (NFS) and visceral fat area was evaluated by Sperman's rank correlation analysis, and visceral fat area and NFS subject operating characteristic (ROC) curves were created to explore the assessment efficacy of visceral fat area in predicting the severity of NAFLD patients. Results Visceral fat area was significantly higher in patients with NAFLD than in controls (F=43.413, P< 0.05) and was proportional to disease severity. Correlation analysis showed that visceral fat area in patients with NAFLD was positively correlated with NFS (r=0.293, P< 0.05) and degree of hepatic steatosis (r=0.697, P< 0.05), with no significant correlation with age and body mass index.ROC curve analysis showed that visceral fat area predicted AUC in patients with mild, moderate, and severe NAFLD of Visceral fat area predicted mild and moderate NAFLD better than NFS (Z=3.987, P< 0.001;Z=2.253, P=0.024); NFS predicted severe NAFLD better than visceral fat area (Z=2.274, P=0.023).Conclusions Visceral fat area levels are significantly elevated in patients with NAFLD and can be used as a potential indicator to assist in the diagnosis of mild to moderate NAFLD. |
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