Correlation of multiple lipid and lipoprotein ratios with nonalcoholic fatty liver disease in patients with newly diagnosed type 2 diabetic mellitus: A retrospective study.
Correlation of multiple lipid and lipoprotein ratios with nonalcoholic fatty liver disease in patients with newly diagnosed type 2 diabetic mellitus: A retrospective study.
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DOI：
10.3389/fendo.2023.1127134
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发表时间：
2023
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
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在新诊断的T2 DM中，脂质和脂蛋白比率对NAFLD的诊断价值尚不清楚。本研究旨在探讨新诊断的T2 DM受试者中血脂和脂蛋白比值与NAFLD风险之间的关系。共有371例新诊断的T2 DM伴NAFLD患者和360例新诊断的T2 DM不伴NAFLD患者入组研究。收集受试者的人口统计学变量、临床病史和血清生化指标。计算甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值、胆固醇/HDL-C（TC/HDL-C）比值、游离脂肪酸/HDL-C（FFA/HDL-C）比值、尿酸/HDL-C（UA/HDL-C）比值、低密度脂蛋白胆固醇/HDL-C（LDL-C/HDL-C）比值、载脂蛋白B/载脂蛋白A1（APOB/A1）比值。比较NAFLD组与非NAFLD组血脂和脂蛋白比值的差异，并进一步分析这些比值与初诊T2 DM患者NAFLD风险的相关性及诊断价值。新诊断的T2 DM患者中NAFLD的比例在6个脂质比值的Q1至Q4范围内进行性增加，包括TG/HDL-C比值、TC/HDL-C比值、FFA/HDL-C比值、UA/HDL-C比值、LDL-C/HDL-C比值和APOB/A1比值。在调整多个混杂因素后，TG/HDL-C、TC/HDL-C、UA/HDL-C、LDL-C/HDL-C和APOB/A1均与新诊断的T2 DM患者的NAFLD风险强相关。在新发T2 DM患者中，TG/HDL-C比值是所有6项指标中诊断NAFLD的最有力指标，曲线下面积（AUC）为0.732（95%CI 0.696-0.769）。此外，TG/HDL-C比值>1.405，对初诊T2 DM患者NAFLD的诊断敏感性为73.8%，特异性为60.1%，具有较好的诊断价值。TG/HDL-C比值可能是一个有效的指标，以帮助识别新诊断的T2 DM患者的NAFLD的风险。
The diagnostic value of lipid and lipoprotein ratios for NAFLD in newly diagnosed T2DM remains unclear. This study aimed to investigate the relationships between lipid and lipoprotein ratios and the risk of NAFLD in subjects with newly diagnosed T2DM. A total of 371 newly diagnosed T2DM patients with NAFLD and 360 newly diagnosed T2DM without NAFLD were enrolled in the study. Demographics variables, clinical history and serum biochemical indicators of the subjects were collected. Six lipid and lipoprotein ratios, including triglycerides to high-density lipoprotein-cholesterol (TG/HDL-C) ratio, cholesterol to HDL-C (TC/HDL-C) ratio, free fatty acid to HDL-C (FFA/HDL-C) ratio, uric acid to HDL-C (UA/HDL-C) ratio, low-density lipoprotein-cholesterol to HDL-C (LDL-C/HDL-C) ratio, apolipoprotein B to apolipoprotein A1 (APOB/A1) ratio, were calculated. We compared the differences in lipid and lipoprotein ratios between NAFLD group and non-NAFLD group, and further analyzed the correlation and diagnostic value of these ratios with the risk of NAFLD in the newly diagnosed T2DM patients. The proportion of NAFLD in patients with newly diagnosed T2DM increased progressively over the range Q1 to Q4 of six lipid ratios, including the TG/HDL-C ratio, TC/HDL-C ratio, FFA/HDL-C ratio, UA/HDL-C ratio, LDL-C/HDL-C ratio, and APOB/A1 ratio. After adjusting for multiple confounders, TG/HDL-C, TC/HDL-C, UA/HDL-C, LDL-C/HDL-C and APOB/A1 were all strongly correlated with the risk of NAFLD in patients with newly diagnosed T2DM. In patients with newly-onset T2DM, the TG/HDL-C ratio was the most powerful indicator for the diagnosis of NAFLD among all six indicators, with an area under the curve (AUC) of 0.732 (95% CI 0.696–0.769). In addition, TG/HDL-C ratio>1.405, with a sensitivity of 73.8% and specificity of 60.1%, had a good diagnostic ability for NAFLD in patients with newly diagnosed T2DM. The TG/HDL-C ratio may be an effective marker to help identify the risk of NAFLD in patients with newly diagnosed T2DM.