糖尿病晚期肝纤维化患者血糖状态、R因子与脂肪变性相关纤维化评分的关系

Q2 Medicine

Obesity Medicine Pub Date : 2025-01-01 DOI:10.1016/j.obmed.2024.100575

Mohammadjavad Sotoudeheian , Seyed-Mohamad-Sadegh Mirahmadi , Reza Azarbad

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引用次数: 0

摘要

利用AimsR因子和脂肪变性相关纤维化估计器（SAFE）评分来评价它们与糖尿病（DM）患者肝纤维化的血糖控制和无创检查之间的关系。方法采用2017-2018年全国健康与营养调查（NHANES）数据库，纳入糖尿病患者或糖蛋白水平6.5%及以上的参与者。计算每位受试者的R因子、SAFE评分、FIB-4、FIB-8、脂肪肝指数（FLI）、肝脂肪变性指数（HSI）、糖尿病血糖风险评估方程（GRADE）、McAuley指数和定量胰岛素敏感性检查指数（QUICKI）。利用Pearson相关和受试者工作特征曲线下面积（AUROC）进行分析。结果在885名糖尿病参与者中，SAFE评分与肝脏硬度有中度相关性(r = 0.34, p <；0.0001)，与CAP呈弱相关（r = 0.11, p = 0.0011）。R因子与肝纤维化标志物的相关性较弱。SAFE评分与FIB-4和FIB-8呈正相关(r = 0.78, p <；0.0001)。血糖指标与SAFE评分和R因子呈混合相关性。在检测糖尿病患者的晚期肝纤维化方面，SAFE评分显示出良好的准确性（AUROC = 0.717, 95%可信区间：0.667-0.768），优于其他非侵入性检查。结论SAFE评分和R因子与糖尿病患者肝纤维化标志物相关，其中SAFE评分相关性略强。血糖状态指标和肝纤维化指标之间的复杂关系表明，糖尿病患者的肝脏健康可能与当前的血糖控制并不成正比。

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The association between glycemic state, R factor and Steatosis-Associated Fibrosis Estimator score in advanced liver fibrosis in patients with diabetes mellitus

Aims

R factor and Steatosis-Associated Fibrosis Estimator (SAFE) score utilized to evaluate the connection between them and glycemic control and non-invasive tests in liver fibrosis among patients with diabetes mellitus (DM).

Methods

The 2017–2018 National Health and Nutrition Examination Survey (NHANES) database was used and participants with DM or those with glycohemoglobin levels of 6.5% or higher were included. The R factor, the SAFE score, FIB-4, FIB-8, Fatty Liver Index (FLI), Hepatic steatosis index (HSI), Glycemic Risk Assessment in Diabetes Equation (GRADE), McAuley's Index, and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated for each participant. The Pearson's correlation and area under the receiver operating characteristic (AUROC) curve were utilized.

Results

Among 885 diabetic participants, the SAFE score had a moderate correlation with liver stiffness (r = 0.34, p < 0.0001) and weak correlation with CAP (r = 0.11, p = 0.0011). The R factor demonstrated weaker correlations with liver fibrosis markers. The SAFE score strongly correlated with FIB-4 and FIB-8 (both r = 0.78, p < 0.0001). Glycemic markers showed mixed correlations with SAFE score and R factor. The SAFE score demonstrated good accuracy (AUROC = 0.717, 95% confidence interval: 0.667–0.768) in detecting advanced liver fibrosis in diabetic subjects, outperforming other non-invasive tests.

Conclusion

The SAFE score and R factor correlate with liver fibrosis markers in diabetic patients, with the SAFE score showing slightly stronger associations. The complex relationships between glycemic state markers and liver fibrosis indices suggest that liver health in diabetic patients may not be directly proportional to current glycemic control.

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来源期刊

Obesity Medicine Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.50

自引率

0.00%

发文量

审稿时长

40 days

期刊介绍： The official journal of the Shanghai Diabetes Institute Obesity is a disease of increasing global prevalence with serious effects on both the individual and society. Obesity Medicine focusses on health and disease, relating to the very broad spectrum of research in and impacting on humans. It is an interdisciplinary journal that addresses mechanisms of disease, epidemiology and co-morbidities. Obesity Medicine encompasses medical, societal, socioeconomic as well as preventive aspects of obesity and is aimed at researchers, practitioners and educators alike.