观察性研究表明,非酒精性脂肪性肝病(NAFLD)与代谢功能障碍密切相关。然而,关于血清代谢指标的变化是否有助于NAFLD的发展的研究很少。这项研究是在金陵医院接受健康体检的4084名参与者进行的,医学院附属医院,南京大学,南京,中国,2022年和2023年。基线和后续测量,包括人体测量数据,收集腹部超声和血液样本。NAFLD的诊断依据2010年中国NAFLD诊断和治疗指南。利用多元逻辑回归分析1年NAFLD风险的比值比(ORs)与基线代谢指标和1年内观察到的代谢指标变化相关。总共3425名基线无NAFLD的研究参与者,包括1146名男性和2279名女性,包括在最终分析中。平均年龄为34.43±7.20岁。患有NAFLD的参与者年龄较大,男性,身体质量指数(BMI)较高,血压,空腹血糖(FBG),甘油三酯(TG),总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),游离三碘甲状腺原氨酸(fT3),尿酸(UA),谷丙转氨酶(ALT)和谷草转氨酶(AST);和较低水平的高密度脂蛋白胆固醇(HDL-C)和游离甲状腺素(fT4)(所有P值<0.05)。多变量模型显示,基线BMI,舒张压(DBP),TG,TC,HDL-C,LDL-C,UA,fT4,fT3,ALT和TG的变化,HDL-C,UA与NAFLD的1年风险相关。改变的TG值(1.01mmol/L)和改变的UA值(55μmol/L)每增加标准差(SD),NAFLD的风险分别增加56%[OR1.56,95%置信区间(CI)1.32-1.87]和40%(OR1.40,95%CI1.19-1.64)。相反,HDL-C变化每增加SD(0.27mmol/L),NAFLD的1年风险降低了50%(OR0.50,95%CI0.40~0.62).本研究表明,TG和UA的增加,HDL-C的减少,显著增加患NAFLD的风险。因此,在NAFLD的管理和预防中,应更加重视这些因素。
Observational studies have shown that non-alcoholic fatty liver disease (NAFLD) is strongly associated with metabolic dysfunction. However, there is a paucity of research on whether changes in indicators of serum metabolism contribute to the development of NAFLD. This study was conducted with 4084 participants who underwent healthy physical examinations at Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China, in 2022 and 2023. Baseline and follow-up measurements, including anthropometric data, abdominal ultrasound and blood samples were collected. The diagnosis of NAFLD was based on the 2010 Chinese Guidelines on Diagnosis and Treatment of NAFLD. Multiple logistic regression was utilized to analyze the odds ratios (ORs) for the 1-year risk of NAFLD in connection with both baseline metabolic indicators and changes in metabolic indicators observed over the course of 1 year. A total of 3425 study participants who were free of NAFLD at baseline, including 1146 men and 2279 women, were included in the final analysis. The mean age was 34.43 ± 7.20 years. Participants who developed NAFLD were older, male and had higher levels of body mass index (BMI), blood pressure, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), free triiodothyronine (fT3), uric acid (UA), alanine aminotransferase (ALT) and aspartate aminotransferase (AST); and lower levels of high-density lipoprotein cholesterol (HDL-C) and free thyroxine (fT4) (all P values < 0.05). The multivariable model showed that baseline BMI, diastolic blood pressure (DBP), TG, TC, HDL-C, LDL-C, UA, fT4, fT3, ALT and changes in TG, HDL-C, and UA were associated with the 1-year risk of developing NAFLD. The risk of NAFLD increased by 56% [OR 1.56, 95% Confidence Interval (CI) 1.32-1.87] and 40% (OR 1.40, 95% CI 1.19-1.64) for each standard deviation (SD) increase in altered TG values (1.01 mmol/L) and altered UA values (55 µmol/L) respectively. Conversely, for each SD (0.27 mmol/L) increase in HDL-C change, the 1-year risk of incident NAFLD was reduced by 50% (OR 0.50, 95% CI 0.40-0.62). The present study suggested that increases in TG and UA, and decreases in HDL-C, significantly increase the risk of developing NAFLD. Therefore, more attention should be paid to these factors in the management and prevention of NAFLD.