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Abstract：
BACKGROUND: The main objective of this study is to determine the accuracy of different biochemical markers of hepatic steatosis and to correlate liver steatosis with adherence to the Mediterranean diet and level of physical activity.
METHODS: A cross-sectional study was carried out, including subjects over 50 years of age, with a BMI > 25 kg/m2, but excluding any patient with documented hepatic pathology other than hepatic steatosis. Participants were divided into two groups: patients with hepatic steatosis diagnosed by ultrasound (SG) and a control group of individuals without hepatic steatosis (CG). The level of physical activity was recorded by the IPAQ-SF questionnaire and the adherence to the Mediterranean diet was recorded using the PREDIMED questionnaire. Biochemical markers analyzed included the Hepatic steatosis index (HSI), AST-to-Platelet ratio (APRI) and Fibrosis-4 (FIB-4).
RESULTS: A total of 116 patients were included, 71 belonging to the SG and 45 to the CG. A total of 58.6% of the patients showed low adherence to the Mediterranean diet, 35.4% moderate adherence and 6% high adherence. The median estimated physical activity was 495 METS, with most participants reporting light activity. In the SG, significantly higher HSI values were observed (p < 0.001). A cut-off point of a HSI of 40 was established, with a sensitivity of 73.2% and a specificity of 65.8%. Significantly higher FIB-4 values (p = 0.039) were also observed in the SG. A cut-off point of FIB-4 was set at 0.27, with a sensitivity of 69% and a specificity of 57.9%. Patients in the SG showed lower scores in the PREDIMED. Patients in the SG tended to show lower METS scores. However, the higher number of patients with intense activity in the CG group stands out (p = 0.008).
CONCLUSIONS: The HSI and FIB-4 showed a significant correlation with liver steatosis. Hepatic steatosis is associated with low adherence to the Mediterranean diet and patients with hepatic steatosis tended to have lower METS scores.
METHODS: A cross-sectional study was carried out, including subjects over 50 years of age, with a BMI > 25 kg/m2, but excluding any patient with documented hepatic pathology other than hepatic steatosis. Participants were divided into two groups: patients with hepatic steatosis diagnosed by ultrasound (SG) and a control group of individuals without hepatic steatosis (CG). The level of physical activity was recorded by the IPAQ-SF questionnaire and the adherence to the Mediterranean diet was recorded using the PREDIMED questionnaire. Biochemical markers analyzed included the Hepatic steatosis index (HSI), AST-to-Platelet ratio (APRI) and Fibrosis-4 (FIB-4).
RESULTS: A total of 116 patients were included, 71 belonging to the SG and 45 to the CG. A total of 58.6% of the patients showed low adherence to the Mediterranean diet, 35.4% moderate adherence and 6% high adherence. The median estimated physical activity was 495 METS, with most participants reporting light activity. In the SG, significantly higher HSI values were observed (p < 0.001). A cut-off point of a HSI of 40 was established, with a sensitivity of 73.2% and a specificity of 65.8%. Significantly higher FIB-4 values (p = 0.039) were also observed in the SG. A cut-off point of FIB-4 was set at 0.27, with a sensitivity of 69% and a specificity of 57.9%. Patients in the SG showed lower scores in the PREDIMED. Patients in the SG tended to show lower METS scores. However, the higher number of patients with intense activity in the CG group stands out (p = 0.008).
CONCLUSIONS: The HSI and FIB-4 showed a significant correlation with liver steatosis. Hepatic steatosis is associated with low adherence to the Mediterranean diet and patients with hepatic steatosis tended to have lower METS scores.
摘要：
背景：这项研究的主要目的是确定肝脂肪变性的不同生化标志物的准确性，并将肝脂肪变性与坚持地中海饮食和体力活动水平相关联。
方法：进行了横断面研究，包括50岁以上的受试者，BMI>25kg/m2，但不包括任何有除肝性脂肪变性以外的肝病理学记录的患者。参与者分为两组：通过超声（SG）诊断为肝性脂肪变性的患者和没有肝性脂肪变性（CG）的对照组。通过IPAQ-SF问卷记录身体活动水平，并使用PREDIMED问卷记录对地中海饮食的依从性。分析的生化标志物包括肝脏脂肪变性指数（HSI），AST与血小板比率(APRI)和纤维化-4(FIB-4)。
结果：共纳入116例患者，71属于SG，45属于CG。共有58.6%的患者对地中海饮食的依从性低,35.4%的中等依从性和6%的高依从性。估计的体力活动中位数为495METS，大多数参与者报告轻度活动。在SG中,观察到显著更高的HSI值(p<0.001)。恒生指数的分界点为40，敏感性为73.2%，特异性为65.8%。在SG中还观察到显著更高的FIB-4值(p=0.039)。FIB-4的截止点设定为0.27,灵敏度为69%,特异性为57.9%。SG中的患者在PREDIMED中显示较低的评分。SG中的患者倾向于显示较低的METS评分。然而,CG组中有较高数量的强烈活动的患者脱颖而出（p=0.008）。
结论：HSI和FIB-4与肝脏脂肪变性显著相关。肝脂肪变性与地中海饮食依从性低相关，肝脂肪变性患者的METS评分较低。
方法：进行了横断面研究，包括50岁以上的受试者，BMI>25kg/m2，但不包括任何有除肝性脂肪变性以外的肝病理学记录的患者。参与者分为两组：通过超声（SG）诊断为肝性脂肪变性的患者和没有肝性脂肪变性（CG）的对照组。通过IPAQ-SF问卷记录身体活动水平，并使用PREDIMED问卷记录对地中海饮食的依从性。分析的生化标志物包括肝脏脂肪变性指数（HSI），AST与血小板比率(APRI)和纤维化-4(FIB-4)。
结果：共纳入116例患者，71属于SG，45属于CG。共有58.6%的患者对地中海饮食的依从性低,35.4%的中等依从性和6%的高依从性。估计的体力活动中位数为495METS，大多数参与者报告轻度活动。在SG中,观察到显著更高的HSI值(p<0.001)。恒生指数的分界点为40，敏感性为73.2%，特异性为65.8%。在SG中还观察到显著更高的FIB-4值(p=0.039)。FIB-4的截止点设定为0.27,灵敏度为69%,特异性为57.9%。SG中的患者在PREDIMED中显示较低的评分。SG中的患者倾向于显示较低的METS评分。然而,CG组中有较高数量的强烈活动的患者脱颖而出（p=0.008）。
结论：HSI和FIB-4与肝脏脂肪变性显著相关。肝脂肪变性与地中海饮食依从性低相关，肝脂肪变性患者的METS评分较低。
