PDF(Pubmed)
Abstract：
Non-alcoholic fatty liver disease (NAFLD) is increasingly observed in non-obese individuals. The ZJU (Zhejiang University) index has been established as a new and efficient tool for detecting NAFLD, but the relationship between the ZJU index and NAFLD within non-obese individuals still remains unclear.
A post-hoc evaluation was undertaken using data from a health assessment database by the Wenzhou Medical Center. The participants were divided into four groups based on the quartile of the ZJU Index. Cox proportional hazards regression, Kaplan-Meier analysis and tests for linear trends were used to evaluate the relationship between the ZJU index and NAFLD incidence. Subgroup analysis was conducted to test the consistency of the correlation between ZJU and NAFLD in subsgroups. Receiver operative characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the ZJU index, compared with the Atherogenic index of plasma (AIP) and Remnant lipoprotein cholesterol (RLP-C) index.
A total of 12,127 were included in this study, and 2,147 participants (17.7%) developed NAFLD in 5 years follow-up. Participants in higher ZJU quartiles tended to be female and have higher liver enzymes (including ALP, GGT, ALT, AST), GLU, TC, TG, LDL and higher NAFLD risk. Hazard Ratios (HR) and 95% confidence intervals (CI) for new-onset NAFLD in Q2, Q3, and Q4 were 3.67(2.43 to 5.55), 9.82(6.67 to 14.45), and 21.67(14.82 to 31.69) respectively in the fully adjusted model 3. With increased ZJU index, the cumulative new-onset NAFLD gradually increased. Significant linear associations were observed between the ZJU index and new-onset NAFLD (p for trend all<0.001). In the subgroup analysis, we noted a significant interaction in sex, with HRs of 3.27 (2.81, 3.80) in female and 2.41 (2.21, 2.63) in male (P for interaction<0.01). The ZJU index outperformed other indices with an area under the curve (AUC) of 0.823, followed by AIP (AUC=0.747) and RLP-C (AUC=0.668).
The ZJU index emerges as a promising tool for predicting NAFLD risk in non-obese individuals, outperforming other existing parameters including AIP and RLP-C. This could potentially aid in early detection and intervention in this specific demographic.
A post-hoc evaluation was undertaken using data from a health assessment database by the Wenzhou Medical Center. The participants were divided into four groups based on the quartile of the ZJU Index. Cox proportional hazards regression, Kaplan-Meier analysis and tests for linear trends were used to evaluate the relationship between the ZJU index and NAFLD incidence. Subgroup analysis was conducted to test the consistency of the correlation between ZJU and NAFLD in subsgroups. Receiver operative characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the ZJU index, compared with the Atherogenic index of plasma (AIP) and Remnant lipoprotein cholesterol (RLP-C) index.
A total of 12,127 were included in this study, and 2,147 participants (17.7%) developed NAFLD in 5 years follow-up. Participants in higher ZJU quartiles tended to be female and have higher liver enzymes (including ALP, GGT, ALT, AST), GLU, TC, TG, LDL and higher NAFLD risk. Hazard Ratios (HR) and 95% confidence intervals (CI) for new-onset NAFLD in Q2, Q3, and Q4 were 3.67(2.43 to 5.55), 9.82(6.67 to 14.45), and 21.67(14.82 to 31.69) respectively in the fully adjusted model 3. With increased ZJU index, the cumulative new-onset NAFLD gradually increased. Significant linear associations were observed between the ZJU index and new-onset NAFLD (p for trend all<0.001). In the subgroup analysis, we noted a significant interaction in sex, with HRs of 3.27 (2.81, 3.80) in female and 2.41 (2.21, 2.63) in male (P for interaction<0.01). The ZJU index outperformed other indices with an area under the curve (AUC) of 0.823, followed by AIP (AUC=0.747) and RLP-C (AUC=0.668).
The ZJU index emerges as a promising tool for predicting NAFLD risk in non-obese individuals, outperforming other existing parameters including AIP and RLP-C. This could potentially aid in early detection and intervention in this specific demographic.
摘要：
■在非肥胖个体中越来越多地观察到非酒精性脂肪性肝病(NAFLD)。ZJU（浙江大学）指数已被建立为检测NAFLD的新型高效工具，但在非肥胖个体中,ZJU指数与NAFLD之间的关系仍不清楚.
■使用温州医学中心的健康评估数据库中的数据进行了事后评估。根据ZJU指数的四分位数将参与者分为四组。Cox比例风险回归，使用Kaplan-Meier分析和线性趋势检验来评估ZJU指数与NAFLD发病率之间的关系。采用亚组分析检验亚组中ZJU与NAFLD相关性的一致性。进行受试者工作特征（ROC）曲线分析以评估ZJU指数的预测性能，与血浆致动脉粥样硬化指数（AIP）和残余脂蛋白胆固醇（RLP-C）指数进行比较。
■本研究共纳入12,127人，2,147名参与者（17.7%）在5年的随访中发展为NAFLD。ZJU四分位数较高的参与者往往是女性，并且具有较高的肝酶（包括ALP，GGT,ALT,AST),GLU,TC,TG,LDL和更高的NAFLD风险。第二季度、第三季度和第四季度新发NAFLD的危险比（HR）和95％置信区间（CI）为3.67（2.43至5.55），9.82（6.67至14.45），和21.67（14.82至31.69），分别在完全调整后的模型3中。随着ZJU指数的增加，累积新发NAFLD逐渐增加。在ZJU指数和新发NAFLD之间观察到显著的线性关联(趋势p<0.001)。在亚组分析中，我们注意到性别的重要互动，女性的HR为3.27（2.81，3.80），男性为2.41（2.21，2.63）（P<0.01）。ZJU指数优于其他指数，曲线下面积（AUC）为0.823，其次是AIP（AUC=0.747）和RLP-C（AUC=0.668）。
■ZJU指数成为预测非肥胖者NAFLD风险的有前途的工具，表现优于其他现有参数，包括AIP和RLP-C。这可能有助于早期发现和干预这一特定人群。
■使用温州医学中心的健康评估数据库中的数据进行了事后评估。根据ZJU指数的四分位数将参与者分为四组。Cox比例风险回归，使用Kaplan-Meier分析和线性趋势检验来评估ZJU指数与NAFLD发病率之间的关系。采用亚组分析检验亚组中ZJU与NAFLD相关性的一致性。进行受试者工作特征（ROC）曲线分析以评估ZJU指数的预测性能，与血浆致动脉粥样硬化指数（AIP）和残余脂蛋白胆固醇（RLP-C）指数进行比较。
■本研究共纳入12,127人，2,147名参与者（17.7%）在5年的随访中发展为NAFLD。ZJU四分位数较高的参与者往往是女性，并且具有较高的肝酶（包括ALP，GGT,ALT,AST),GLU,TC,TG,LDL和更高的NAFLD风险。第二季度、第三季度和第四季度新发NAFLD的危险比（HR）和95％置信区间（CI）为3.67（2.43至5.55），9.82（6.67至14.45），和21.67（14.82至31.69），分别在完全调整后的模型3中。随着ZJU指数的增加，累积新发NAFLD逐渐增加。在ZJU指数和新发NAFLD之间观察到显著的线性关联(趋势p<0.001)。在亚组分析中，我们注意到性别的重要互动，女性的HR为3.27（2.81，3.80），男性为2.41（2.21，2.63）（P<0.01）。ZJU指数优于其他指数，曲线下面积（AUC）为0.823，其次是AIP（AUC=0.747）和RLP-C（AUC=0.668）。
■ZJU指数成为预测非肥胖者NAFLD风险的有前途的工具，表现优于其他现有参数，包括AIP和RLP-C。这可能有助于早期发现和干预这一特定人群。
