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目的分析非酒精性脂肪肝(NAFLD)发病的危险因素,探讨甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)和谷氨酰转移酶(GGT)对非酒精性脂肪肝(NAFLD)的预测价值。方法于2012年3—9月选取宁波市第一医院的24岁及以上健康体检者335例作为研究对象,纳入后每年随访一次,连续3年,检测其基线水平及随访时谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转移酶(GGT)、甘油三酯(TG)、尿酸(UA)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及空腹血糖(FPG),计算TG/HDL-C。结果 3年后发生NAFLD的人群,其基础体重指数(BMI)、收缩压(SBP)、舒张压(HBP)、TC、TG、UA、FPG、TG/HDL-C、ALT、AST、GGT较无NAFLD组高,HDL-C较无NAFLD组低(P<0.05)。(2)TG/HDL-C、GGT对NAFLD的发生有一定作用,具有更高的诊断敏感性和特异性,TG/HDL-C的曲线下面积为0.723,95%可信区间是(0.632~0.813),GGT的曲线下面积为0.753,95%可信区间是(0.661~0.846),当TG/HDL-C比值为1.396,而GGT在28.0 U/L时对NAFLD的诊断具有一定意义。结论 TG/HDL-C和GGT对NAFLD的诊断具有较高的敏感性和特异性。
Objective To analyze the risk factors of nonalcoholic fatty liver disease (NAFLD) and to explore the effect of triglyceride / high density lipoprotein cholesterol ratio (TG / HDL-C) and glutamyl transferase (GGT) on non-alcoholic fatty liver disease ) Of the predictive value. Methods A total of 335 healthy subjects aged 24 years and over in Ningbo No.1 Hospital from March to September in 2012 were enrolled in this study. The patients were followed up once a year for 3 consecutive years. The baseline levels and ALT ), AST, GGT, TG, UA, TC, LDL-C, high-density Lipoprotein cholesterol (HDL-C) and fasting blood glucose (FPG), calculated TG / HDL-C. Results In the population with NAFLD after 3 years, the basal body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (HBP), TC, TG, UA, FPG, TG / HDL-C, ALT, AST, NAFLD group, HDL-C was lower than NAFLD group (P <0.05). (2) TG / HDL-C and GGT have a certain effect on the occurrence of NAFLD and have higher diagnostic sensitivity and specificity. The area under the curve of TG / HDL-C is 0.723, 95% confidence interval is (0.632 ~ 0.813). The area under the curve of GGT was 0.753, the 95% confidence interval was (0.661-0.846). When the ratio of TG / HDL-C was 1.396 and GGT was 28.0 U / L, it had some significance for the diagnosis of NAFLD. Conclusion TG / HDL-C and GGT have high sensitivity and specificity for the diagnosis of NAFLD.