PDF(Pubmed)
Abstract：
There is limited research on the association between the alanine aminotransferase to high-density lipoprotein cholesterol ratio (ALT/HDL-C) ratio and nonalcoholic fatty liver disease (NAFLD). The purpose of the current research was to look into the connection between the ALT/HDL-C ratio and the risk of NAFLD in lean Chinese individuals. Between January 2010 and December 2014, 11,975 non-obese people participated in this prospective cohort research. The relationship between the ALT/HDL-C ratio and the risk of developing NAFLD was assessed using the Cox proportional-hazards regression model, Cox proportional hazards regression with cubic spline functions and smooth curve fitting, sensitivity analysis, and subgroup analyses. The ALT/HDL-C ratio\'s potential value as a NAFLD prognostic marker was to be evaluated using the receiver operating characteristic curve analysis. A total of 5419 (45.253%) women comprised the research\'s participant population, and the research participants\' average age was 43.278 ± 14.941 years. The ALT/HDL-C ratio was 11.607 (7.973-17.422) at the median (interquartile ranges). 2087 (17.428%) patients had NAFLD diagnoses throughout a median follow-up of 24.967 months. The study\'s findings demonstrated a positive connection between the ALT/AHDL-C ratio and the incident NAFLD (HR = 1.037, 95% CI: 1.031-1.042) when adjusting for relevant factors. The ALT/HDL-C ratio and NAFLD risk had a nonlinear connection, with 12.963 as the ratio\'s inflection point. Effect sizes (HR) were 1.023 (95% CI: 1.017-1.029) and 1.204 (95% CI: 1.171-1.237), respectively, on the right and left sides of the inflection point. The sensitivity analysis also showed how reliable our findings were. According to subgroup analysis, those with BMI < 24 kg/m2 and DBP < 90 mmHg had a stronger correlation between the ALT/HDL-C ratio and NAFLD risk. The current study shows a positive and non-linear connection between the ALT/HDL-C ratio and NAFLD risk in lean Chinese individuals. When the ALT/HDL-C ratio is less than 12.963, it is significantly linked to NAFLD. Therefore, from a therapy standpoint, it is advised to keep the ALT/HDL-C ratio less than the inflection point.
摘要：
关于丙氨酸转氨酶与高密度脂蛋白胆固醇比值（ALT/HDL-C）与非酒精性脂肪性肝病（NAFLD）之间的相关性研究有限。当前研究的目的是研究ALT/HDL-C比值与中国瘦肉个体NAFLD风险之间的联系。2010年1月至2014年12月，11,975名非肥胖者参与了这项前瞻性队列研究。使用Cox比例风险回归模型评估ALT/HDL-C比值与发生NAFLD的风险之间的关系，用三次样条函数和平滑曲线拟合进行Cox比例风险回归，敏感性分析，和亚组分析。ALT/HDL-C比值作为NAFLD预后标志物的潜在价值将使用受试者工作特征曲线分析进行评估。共有5419名(45.253%)女性参与研究，研究参与者的平均年龄为43.278±14.941岁。ALT/HDL-C比率在中位数（四分位数范围）为11.607（7.973-17.422）。在24.967个月的中位随访期间，2087例（17.428%）患者诊断为NAFLD。研究结果表明，当调整相关因素时，ALT/AHDL-C比值与NAFLD之间存在正相关关系（HR=1.037，95％CI：1.031-1.042）。ALT/HDL-C比值和NAFLD风险存在非线性联系，以12.963为比率的拐点。效应大小（HR）分别为1.023（95％CI：1.017-1.029）和1.204（95％CI：1.171-1.237），分别,在拐点的左右两侧。敏感性分析还显示了我们的发现有多可靠。根据亚组分析，BMI<24kg/m2和DBP<90mmHg的患者ALT/HDL-C比值与NAFLD风险之间的相关性更强.目前的研究表明，在中国瘦肉个体中，ALT/HDL-C比率与NAFLD风险之间存在正相关和非线性关系。当ALT/HDL-C比率小于12.963时,其与NAFLD显著相关。因此,从治疗的角度来看，建议保持ALT/HDL-C比值低于拐点。
