广东医学2025，Vol.46Issue(12)：1809-1820,12.DOI:10.13820/j.cnki.gdyx.20253444
成人肥胖与脂质相关指数对脂肪肝预测价值的比较
Comparative predictive value of adult obesity and lipid-related indices for fatty liver
摘要
Abstract
Objective To evaluate twelve obesity-and lipid-related indices,including lipid accumulation product(LAP),body mass index(BMI),visceral adiposity index(VAI),Chinese visceral adiposity index(CVAI),abdominal volume index(AVI),body adiposity index(BAI),body roundness index(BRI),a body shape index(AB-SI),triglyceride-glucose index(TyG),and its combined indices(TyG-BMI,TyG-waist circumference[TyG-WC],TyG-waist-to-height ratio[TyG-WHtR]),for screening and predicting fatty liver,and to identify the most suitable predictive factors.Methods A retrospective study was conducted on 3 213 individuals undergoing routine health check-ups,categorized into fatty liver(n=1 455)and non-fatty liver(n=1 758)groups.Binary logistic regression was used to assess the independent association between each index and fatty liver.Receiver operating characteristic(ROC)curves and Delong tests were applied to compare the predictive performance of these indices.Results In the o-verall population and men,all indices were significant risk factors for fatty liver(P＜0.05).In women,all indices except ABSI were significant(P＜0.05).ROC analysis showed that TyG-WHtR was the optimal predictor for the overall popu-lation(AUC=0.856),women(AUC=0.878),and young men(AUC=0.848).TyG-WC was the best predictor for overall men(AUC=0.839),middle-aged and older men(AUC=0.843 and 0.795),and middle-aged women(AUC=0.834).Delong tests indicated that in the overall population,TyG-WHtR outperformed most single indices(P＜0.05),though no significant differences were observed when compared with LAP,TyG-WC,or TyG-BMI(P＞0.05).In men,TyG-WC outperformed most indices(P＜0.05),with no significant difference versus TyG-BMI and TyG-WHtR.In women,TyG-WHtR outperformed most indices(P＜0.05),with no significant difference versus LAP,CVAI,TyG-WC,or TyG-BMI.Conclusion TyG-WHtR and TyG-WC are highly effective non-invasive predic-tors of fatty liver.Gender-specific application is recommended(TyG-WC for men,TyG-WHtR for women),while LAP can serve as a simple screening tool in primary care settings.关键词
脂肪肝/肥胖相关指标/脂质相关指标/预测价值/TyG联合指数Key words
fatty liver/obesity-related indices/lipid-related indices/predictive value/TyG combined indices分类
医药卫生引用本文复制引用
LI Hong,LI Wei,DING Yan-ping,NONG Yun-cui,XUE Li,PAN Liu-xian..成人肥胖与脂质相关指数对脂肪肝预测价值的比较[J].广东医学,2025,46(12):1809-1820,12.基金项目
广西重点研发计划项目(桂科AB22080094) （桂科AB22080094）
广西卫生健康委员会自筹经费科研课题(Z-A20220144) （Z-A20220144）
