HDL-C和BMI水平作为MASLD检测的参数

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-04-01 DOI:10.1016/j.aohep.2025.101881

Stefanny Cornejo-Hernández , Esly Esquivel-Alarcón , Reyna Hernández-Espinoza , J. Salvador García-Hernández , Trinidad Baldovinos-Hernández , Javier Bastida-Alquicira , Eira Cerda-Reyes , Adriana Martinez-Cuazitl

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引用次数: 0

摘要

简介和目的肝脂肪变性伴代谢功能障碍（MASLD）在世界范围内的患病率为30%，其中80%的患者没有出现肝脏生化改变，因此了解是否有任何生化参数有助于我们识别这一人群是很重要的。将临床和生化值与瞬时弹性成像测定的纤维化程度和CAP相关联，以获得确定受影响人群的参数。材料和患者纳入符合MASLD标准的患者，他们接受了短暂肝弹性移植（Fibroscan®630 Expert v10720）， APRI, FIB4， NAFLD评分，血细胞计数，肝脏生化，脂质谱，葡萄糖，糖化血红蛋白，凝血时间。(TP、印度卢比)。将其与健康人群对照进行比较。采用SPSS V24程序进行统计分析，连续定量变量以平均值和百分比表示，普通定量变量以频率和百分比表示，进行Spearman相关检验和线性回归分析，得出ROC曲线和约登指数，并确定其敏感性和特异性，p <；0.05有统计学意义。结果纳入81例患者，平均年龄43岁（38岁，50.5岁），合并症：HTS 2例（2.5%），T2D 8例（10%）。对照组（健康）17例。按BMI计算，超重29例（35.8%），1级肥胖33例（40.7%），2级肥胖7例（8.6%）。经CAP分析，S3 31例（38.35），S2 26例（32.1%），S1 7例（8.6%），S0 17例（21%）。I级或II级肥胖患者有2级或3级脂肪变性，Spearman's ρ 0.581 p <；0.001具有中等相关性。两组比较发现，脂肪变性患者的年龄、BMI、CAP、KPa均高于健康人群，白细胞、葡萄糖、甘油三酯、HDL、GGT、Na均高于健康人群，差异均有统计学意义。线性回归分析得到m = -0.617 + 0.062 （BMI） + -0.009 (HDL)， R为0.737。根据公式绘制ROC曲线，曲线下面积为0.979,p = 0.0001，约登指数为0.60，灵敏度为95.2%，特异性为87.5%。纤维化9例，年龄47.4±14.2岁。纤维化患者中最常见的分级为F2，如表所示。结论shdl水平和BMI可作为MASLD的诊断指标。需要更多的人群来验证它。

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HDL-C and BMI levels as parameters for MASLD detection

Introduction and Objectives

Hepatic Steatosis Associated with Metabolic Dysfunction (MASLD) has a prevalence of 30% worldwide and 80% of these patients do not present alterations in liver biochemistry, therefore it is important to know if there is any biochemical parameter that helps us identify this population. To correlate clinical and biochemical values with the degree of fibrosis and CAP determined by Transient Elastography to obtain a parameter that determines the affected population.

Materials and Patients

Patients with MASLD criteria were included, who underwent transient hepatic elastograft (Fibroscan® 630 Expert v10720), APRI, FIB4, NAFLD score, blood count, liver biochemistry, lipid profile, glucose, glycosylated hemoglobin, clotting times. (TP, INR). It was compared with a control of healthy people. The statistical analysis was used SPSS V24 program for continuous quantitative variables expressed in mean and percentage, the ordinary quantitative variables were expressed in frequencies and percentages, Spearman correlation tests and a linear regression analysis were performed, from which A ROC curve and the Youden index were performed and their sensitivity and specificity were determined, with a statistically significant p <0.05.

Results

81 patients were included, mean age 43 years (38, 50.5), with the following comorbidities: 2 (2.5%) HTS, 8 (10%) T2D. The control group (healthy) was 17. By BMI, 29 (35.8%) were overweight, 33 (40.7%) were grade I obese, and 7 (8.6%) were grade II obese.

By CAP, 31 (38.35) had S3, 26 (32.1%) S2, 7 (8.6%) S1 and 17 (21%) S0. Patients with obesity I or II have grade 2 or 3 steatosis, with a moderate correlation Spearman's rho 0.581 p <0.001.

Both groups were compared, reporting that the age, BMI, CAP and KPa of patients with steatosis are higher compared to healthy participants, as well as leukocytes, glucose, triglycerides, HDL, GGT and Na with statistical significance. The linear regression analysis showed the following formula m = -0.617 + 0.062 (BMI) + -0.009 (HDL), with an R of 0.737. An ROC curve was made with the formula obtained with an area under the curve of 0.979 and a p of <0.0001, having a Youden index with a cut-off point of 0.60, obtaining a sensitivity of 95.2% and a specificity of 87.5%. Regarding fibrosis, 9 patients with fibrosis were detected, whose age is 47.4 ± 14.2 years. The most common grade in patients with fibrosis was F2, as shown in the table.

Conclusions

HDL levels and BMI could be markers to suspect MASLD. A larger population is required to validate it.

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.