实用临床医药杂志2026，Vol.30Issue(3)：16-23,8.DOI:10.7619/jcmp.20255456
内脏脂肪代谢指标与脂肪性肝病肝纤维化的相关性:基于NHANES横断面调查
Correlations between visceral fat metabolism indices and liver fibrosis in steatotic liver disease:a cross-sectional study based on NHANES
摘要
Abstract
Objective To investigate the associations of visceral fat metabolism indices[the Metabolic Score for Visceral Fat(METS-VF),the Metabolic Score for Insulin Resistance(METS-IR),the lipid accumulation product(LAP),the visceral adiposity index(VAI),and the cardiometabolic index(CMI)]with liver fibrosis in individuals with steatotic liver disease(SLD).Methods Based on data of year 2017 to 2020 from the National Health and Nutrition Examination Survey(NHANES),weigh-ted multivariate Logistic regression and trend analysis were used to explore the relationships between visceralfat metabolism indices and liver fibrosis in SLD.Restricted cubic spline models were constructed to examine potential nonlinear relationships.Receiver operating characteristic(ROC)curves were plotted to briefly evaluate the diagnostic performance of visceral fat metabolism indices for liver fibro-sis.Results In the entire SLD population and the metabolic dysfunction-associated steatotic liver disease(MASLD)subgroup(92.6％),the Logistic regression analysis revealed that METS-VF,METS-IR,and LAP were significantly positively associated with the risk of liver fibrosis,with risks increasing progressively across quartiles of these indices(Ptrend＜0.01).In fully adjusted models,the highest quartiles of these indices were associated with a significantly elevated risk of liver fibrosis(OR for the entire population:25.622,11.426 and 5.651,respectively;OR for the MASLD sub-group:29.538,18.346 and 5.526,respectively;all P＜0.01).Restricted cubic spline analysis indicated that METS-VF exhibited a linear association with liver fibrosis in both the entire population and the MASLD subgroup(Poverall＜0.05,Pnon-linear＞0.05);METS-IR showed a nonlinear associa-tion with liver fibrosis in the MASLD subgroup(Poverall＜0.05,Pnon-linear＜0.05);METS-IR demon-strated a linear association with liver fibrosis in the entire SLD population(Poverall＜0.05,Pnon-linear=0.251);LAP and CMI exhibited nonlinear associations with liver fibrosis in both the entire SLD population and the MASLD subgroup(Poverall＜0.05,Pnon-linear＜0.05).ROC curve analysis further confirmed that in both the entire SLD population and the MASLD subgroup,the predictive perform-ance(area under the curve values)of METS-VF and METS-IR for liver fibrosis were significantly superior to those of traditional indices(P＜0.001).Conclusion The risk of liver fibrosis in SLD increases significantly with rising METS-VF,suggesting its potential as a non-invasive screening tool for liver fibrosis in SLD.关键词
美国国家健康与营养检查调查/肝纤维化/肝硬化/代谢功能障碍相关脂肪性肝病/代谢性内脏脂肪评分/胰岛素抵抗代谢评分/脂质蓄积指数/内脏脂肪指数/心脏代谢指数分类
医药卫生引用本文复制引用
尚琪,贺改霞,梁肖,杜紫薇,张帅..内脏脂肪代谢指标与脂肪性肝病肝纤维化的相关性:基于NHANES横断面调查[J].实用临床医药杂志,2026,30(3):16-23,8.基金项目
国家自然科学基金青年科学基金项目(81802455) （81802455）
陕西省自然科学基金项目(2019JQ-962) （2019JQ-962）
