内脏脂肪指数对瘦型人群中非酒精性脂肪性肝病的预测价值:一项横断面研究

Objective To explore the association between visceral adiposity index (VAI) and nonalcoholic fatty liver disease (NAFLD) in lean population and the predictive value of VAI. Methods A total of 2 576 healthy subjects, body mass index (BMI) <24 kg/mz, from The Second Affiliated Hospital of Xi'an Jiaotong University from June 2020 to May 2021 were randomly included and divided into lean NAFLD (n = 213) and healthy control group (n = 2 363). According to the VAI quartiles, they were divided into Ql-QA groups from low to high. The differences in biochemical parameters and the prevalence of NAFLD were compared among groups. The correlation between VAI and lean NAFLD was analyzed with restricted cubic spline (RCS), and the predictive value of VAI was explored by Logistic regression and receiver operating characteristic (ROC) curve. Results A total of 2 576 participants were included, and the prevalence of lean NAFLD was 8.3% (213 cases). The mean age, male ratio, BMI and waist circumference (WC) from group Q\ to group QA were significantly increased in a dose-response relationship (all P<0.001). Compared with those in group Q\ ¦ systolic blood pressure, diastolic blood pressure, white blood cell count, hemoglobin concentration, alanine aminotransferase, aspartate aminotransferase, y-glutamyl transpeptidase, alkaline phosphatase, total cholesterol, triglyceride, low-density lipoprotein cholesterol, blood uric acid, and fasting blood glucose levels in groups Q2 to QA were significantly increased, while direct bilirubin and high-density lipoprotein cholesterol levels were gradually decreased (both P< 0.001). The prevalence rate of NAFLD in groups Q1 - Q4 was 0.6 %, 3.3%, 7.0 % and 22.2 %, respectively (P<0.001). RCS showed that the risk of NAFLD in lean population rose significantly with the increase of VAI (P< 0.001), and there was a nonlinear relationship between them (P for nonlinear < 0.001). Logistic regression showed that after adjusting other confounding factors, the risk of lean NAFLD in groups Q2, Q'i and Q4 was still 2.926 times (95% CI¦. 0.971-8.811), 3.435 times (95% CF¦. 1.154-10.230), and 5.920 times (95% CI ¦. 1.873-18.719) that Q\ group. ROC curve showed that VAI had a good predictive value for lean NAFLD, with area under the curve of 0.815, critical value of 1.532, diagnostic sensitivity of 77.9% and specificity of 72.8%, which were better than BMI and WC. Conclusion VAI is significantly associated with the risk of NAFLD in lean population, and thus has a good predictive value. It can be used for early screening and diagnosis of lean NAFLD.