背景:非酒精性脂肪性肝病(NAFLD)已成为青少年的重要健康问题。尽管已经研究了一些参数和指标来评估成人的NAFLD,这些指数在青少年中是有限的。在这项研究中,身体质量指数,腰围,三体质量指数,HbA1c,稳态模型评估胰岛素抵抗(HOMA-IR),甘油三酯/高密度脂蛋白(Tg/HDL),脂质积累产物(LAP)指数,同时检测甘油三酯-葡萄糖(TyG)指数和转氨酶(AT)指数,并比较其在NAFLD临床治疗中的诊断价值。
方法:本研究包括2022年1月至8月期间入住儿科诊所并被诊断为外源性肥胖且没有任何合并症的Seventynine青少年(10-19岁)。通过肝脏磁共振成像评估NAFLD的存在。实验室检查结果是从系统记录中回顾性获得的。在NAFLD(+)和NAFLD(-)组之间比较参数。Logistic回归分析用于确定NAFLD治疗的最有效因素。接收器工作特性(ROC)分析具有重要指标。性,HOMA-IR,评估TyG和AT指数并进行多变量分析以设计诊断量表。
结果:HbA1c,HOMA-IR,NAFLD(+)组的AT指数和TyG指数较高(P=0.012;P=0.001;P=0.012;P=0.002)。肝脏脂肪百分比与HOMA-IR呈正相关,TyG指数,AT指数,和Tg/HDL。根据回归分析,男性和HOMA-IR升高被确定为NAFLD存在的显著危险因素.具有4个参数的概率量表[性别,HOMA-IR,TyG指数,和丙氨酸氨基转移酶(ALT)]的设计具有82.5%的特异性和80%的灵敏度。
结论:HOMA-IR和TyG指数的评估,尤其是高危患者,将通过超声检查支持NAFLD的诊断。ALT的概率量表,HOMA-IR,TyG,诊断准确率为80%的性别数据可能有助于青少年肥胖患者NAFLD的诊断.
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has become an important health issue in adolescents. Although several parameters and indices have been investigated for the evaluation of NAFLD in adults, these indices are limited in adolescents. In this study, body mass index, waist circumference, triponderal mass index, HbA1c, homeostatic model assessment insulin resistance (HOMA-IR), triglyceride/high-density lipoprotein (Tg/HDL), the lipid accumulation product (LAP) index, the triglyceride-glucose (TyG) index and the aminotransferase (AT) index were examined together, and their diagnostic values in the clinical treatment of NAFLD were compared.
METHODS: Seventynine adolescents (10-19 years old) with obesity who were admitted to a pediatric clinic between January and August 2022 and who were diagnosed with exogenous obesity without any comorbidities were included in the study. The presence of NAFLD was evaluated by liver magnetic resonance imaging. The laboratory findings were obtained retrospectively from system records. Parameters were compared between the NAFLD (+) and NAFLD (-) groups. Logistic regression analysis was used to determine the most effective factors for NAFLD treatment. Receiver operating characteristic (ROC) analysis was performed with significant indices. Sex, HOMA-IR, TyG and AT indices were evaluated together with multivariate analysis to design a diagnostic scale.
RESULTS: HbA1c, HOMA-IR, AT indices and TyG indices were greater in the NAFLD (+) group (P = 0.012; P = 0.001; P = 0.012; P = 0.002, respectively). There was a positive correlation between liver fat percentage and HOMA-IR, the TyG index, the AT index, and Tg/HDL. According to the regression analysis, male sex and elevated HOMA-IR were determined to be significant risk factors for the presence of NAFLD. A probability scale with 4 parameters [sex, HOMA-IR, the TyG index, and alanine aminotransferase (ALT)] was designed with 82.5% specificity and 80% sensitivity.
CONCLUSIONS: Evaluation of the HOMA-IR and TyG indices, especially in high-risk patients, will support the diagnosis of NAFLD via ultrasonography. A probability scale with ALT, HOMA-IR, TyG, and sex data with a diagnostic accuracy of 80% may aid in the diagnosis of NAFLD in adolescents with obesity.