Appendicular Skeletal Muscle Index and HbA1c Evaluate Liver Steatosis in Patients With Metabolic Associated Fatty Liver Disease.
Appendicular Skeletal Muscle Index and HbA1c Evaluate Liver Steatosis in Patients With Metabolic Associated Fatty Liver Disease.
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阑尾骨骼肌指数和 HbA1c 评估代谢相关脂肪肝患者的肝脏脂肪变性
DOI：
10.3389/fmed.2022.919502
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发表时间：
2022
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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作者：
背景与目的肝脂肪变性是代谢相关性脂肪性肝病（metabolic associated fatty liver disease，MAFLD）的主要特征，与肝纤维化和代谢综合征的进展密切相关，需要准确评估。本研究旨在探讨脂肪性脂肪肝（MAFLD）患者脂肪肝程度的评估中，非脂肪性骨骼肌指数（ASMI）的意义。方法收集2017 - 2018年全国健康与营养检查调查（NHANES）数据库中899例MAFLD患者。所有分析数据均来自NHANES数据库。使用R和EmpowerStats评估ASMI与肝脏脂肪变性之间的关联。结果MAFLD个体被随机分为培训队列（n = 450）和验证队列（n = 449）。在单因素分析中，HbA1c、手臂脂肪、手臂瘦体重、腿部瘦体重、躯干瘦体重、总脂肪、总瘦体重和ASMI与肝脏脂肪变性显著相关（p <0.05）。多变量分析显示，HbA1c（OR：1.6732; 95% CI：1.2753 - 2.1929，p = 0.0002）和ASMI（OR：1.6723; 95% CI：1.1760 - 2.5204，p = 0.0052）与重度肝脏脂肪变性独立相关。ASMI准确地评估了严重的肝脏脂肪变性，在训练和验证队列中AUROC分别为0.73和0.81。与单独ASMI相比，ASMI联合HbA1c使AUROC提高至0.85和0.88。此外，我们的模型的AUROC在评估肝脏脂肪变性方面优于FLI上级。结论ASMI联合HbA1c对MAFLD患者肝脏脂肪变性有较好的评估价值，有助于临床对MAFLD的治疗。
Background and Aim(s) Liver steatosis, as the main feature of metabolic associated fatty liver disease (MAFLD), was associated with the progression of liver fibrosis and metabolic syndrome, which needed to be estimated accurately. In this study, we explored the significance of appendicular skeletal muscle index (ASMI) in evaluating liver steatosis of MAFLD patients. Methods Eight hundred and ninety-nine cases with MAFLD from 2017 to 2018 National Health and Nutrition Examination Surveys (NHANES) database were included. All the analyzed data were obtained from NHANES database. The association between ASMI and liver steatosis were evaluated using R and EmpowerStats. Results MAFLD individuals were randomly divided into a training (n = 450) and validation cohort (n = 449). In univariate analysis, HbA1c, arms fat, arms lean mass, legs lean mass, trunk lean mass, total fat, total lean mass and ASMI were significantly associated with liver steatosis (p < 0.05). Multivariate analysis showed that HbA1c (OR: 1.6732; 95% CI: 1.2753–2.1929, p = 0.0002) and ASMI (OR: 1.6723; 95% CI: 1.1760–2.5204, p = 0.0052) were independently associated with severe liver steatosis. ASMI accurately evaluated severe liver steatosis with an AUROC of 0.73 and 0.81 in training and validation cohort, respectively. Compared with ASMI only, ASMI combined with HbA1c improved the AUROC to 0.85 and 0.88. Furthermore, the AUROC of our model was superior to FLI in the evaluation of liver steatosis. Conclusion ASMI combined with HbA1c has good evaluation value for liver steatosis in MAFLD patients, which might be beneficial for the management of MAFLD clinically.
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DOI：
10.1016/j.cgh.2020.07.030
发表时间：
2021-07
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
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Fitness, Life Enhancement, and Exercise in Liver Transplantation Consortium
影响因子：
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