FIB-4在代谢相关脂肪性肝病合并结直肠腺瘤性息肉患者的预测价值

doi:10.3969/j.issn.1004-583X.2022.04.009

摘要/Abstract

摘要：

目的探讨FIB-4指数在代谢相关脂肪性肝病(metabolic fatty liver disease, MAFLD)合并结直肠腺瘤性息肉患者的预测价值。方法选取锦州市中心医院消化科2020年5月-2021年6月符合纳入标准的患者183例,息肉病理类型为增生性或炎性息肉的纳入对照组(44例),病理类型为腺瘤性息肉的纳入腺瘤组(139例),收集患者一般资料,计算FIB-4指数,比较两组各指标有无差异;用多因素Logistic回归分析MAFLD合并结直肠腺瘤性息肉发病危险因素,绘制ROC曲线,分析FIB-4指数在MAFLD合并结直肠腺瘤性息肉患者中的预测价值。结果腺瘤组年龄、性别、吸烟史、糖尿病史、体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、FIB-4均高于对照组,腺瘤组高密度脂蛋白胆固醇(HDL-C)、血小板计数(PLT)低于对照组,差异均有统计学意义(P<0.05)。两组饮酒史、高血压病史、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、血尿酸(UA)差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,年龄、性别、BMI、AST、FIB-4指数为MAFLD合并结直肠腺瘤性息肉的独立危险因素(P<0.05)。FIB-4风险评估中的AUC为0.868,灵敏度和特异度分别为67.6%、90.9%。结论 FIB-4指数在MAFLD合并结直肠腺瘤性息肉患者中有预测价值,可帮助初筛腺瘤性息肉发病高危人群,达到早发现早治疗的目的。

关键词: 代谢相关脂肪性肝病, 结直肠腺瘤性息肉, FIB-4

Abstract:

Objective To study the predictive value of FIB-4 index in patients with metabolic-associated fatty liver disease(MAFLD) complicated with colorectal adenomatous polyps. Methods Eligible 183 patients from Department of Gastroenterology, Jinzhou Central Hospital during May 2020 to June 2021 were enrolled. In accordance with pathological type, those with of hyperplastic or inflammatory polyps were included in the control group (44 cases), and those with adenomatous polyps in the adenoma group (139 cases), aiming to compare the interclass differences involving baseline information, FIB-4 index, the risk factors of MAFLD complicated with colorectal adenomatous polyps was analyzed by Multivariate logistic regression, and the predictive value of FIB-4 index for that were assessed by drawing receiver operating characteristic (ROC) curve. Results The adenoma group had older age, longer smoking history and diabetes history, elevated body mass index (BMI), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and FIB-4 (vs control group); while High-density lipoprotein cholesterol (HDL-C) and Platelet count (PLT) in adenoma group were lower than those in control group, with statistical significance differences (P<0.05). The difference in drinking history, hypertension history, Fasting blood glucose(FBG), total cholesterol (TC), triglyceride (TG), and uric acid (UA) between groups was no significant (P>0.05). Multivariate logistic regression analysis indicated that age, gender, BMI, AST and FIB-4 index were independent risk factors for MAFLD complicated with colorectal adenomatous polyps (P<0.05). The AUC of FIB-4 index risk assessment was 0.868, and the sensitivity and specificity were 67.6% and 90.9% respectively.Conclusion FIB-4 index should be attention due to its predictive value for MAFLD complicated with colorectal adenomatous polyps, which can help to identify the high-risk population of adenomatous polyps, early diagnosis and early treatment.

Key words: metabolic fatty liver disease, colorectal adenomatous polyp, FIB-4

中图分类号:

张莉敏, 孙军. FIB-4在代谢相关脂肪性肝病合并结直肠腺瘤性息肉患者的预测价值[J]. 临床荟萃, 2022, 37(4): 334-338.

Zhang Limin, Sun Jun. Predictive value of FIB-4 in patients with metabolic-associated fatty liver disease complicated with colorectal adenomatous polyps[J]. Clinical Focus, 2022, 37(4): 334-338.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.04.009

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I4/334

图/表 3

参考文献 27

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项目	对照组(n=44)	腺瘤组(n=139)	统计值	P值
年龄(岁)	48.32±12.33	54.21±10.48	t=-3.110	0.002
性别(男/女,例)	22/22	108/31	χ²=12.462	0.000
吸烟史(有/无,例)	22/22	103 /36	χ²=8.967	0.003
饮酒史(有/无,例)	26/18	101/38	χ²=2.898	0.089
高血压(有/无,例)	15/29	55/84	χ²=0.045	0.515
糖尿病(有/无,例)	5/39	46/93	χ²=7.430	0.006
BMI(kg/m²)	25.37±2.03	26.74±2.45	t=-3.361	0.001
FBG(mmol/L)	5.57±0.79	5.68±1.00	t=-0.629	0.530
TC(mmol/L)	5.13±0.77	5.28±0.91	t=-1.032	0.304
TG(mmol/L)	1.88(1.48-2.25)	1.93(1.54-2.47)	Z=1.445	0.148
LDL-C(mmol/L)	2.53±0.84	2.93±1.097	t=-2.217	0.028
HDL-C(mmol/L)	1.18±0.47	0.99±0.37	t=2.415	0.019
ALT(U/L)	26.32±9.42	31.12±12.67	t=-2.318	0.022
AST(U/L)	26.98±9.33	38.25±8.07	t=-7.770	0.000
UA(μmol/L)	290.50(234.00-323.50)	297.00(245.00-367.50)	Z=1.081	0.280
PLT(×10⁹/L)	233.59±59.02	200.22±48.33	t=3.777	0.000
FIB-4	1.103(0.743-1.538)	1.908(1.528-2.357)	Z=7.344	0.000

项目	对照组(n=44)	腺瘤组(n=139)	统计值	P值
年龄(岁)	48.32±12.33	54.21±10.48	t=-3.110	0.002
性别(男/女,例)	22/22	108/31	χ²=12.462	0.000
吸烟史(有/无,例)	22/22	103 /36	χ²=8.967	0.003
饮酒史(有/无,例)	26/18	101/38	χ²=2.898	0.089
高血压(有/无,例)	15/29	55/84	χ²=0.045	0.515
糖尿病(有/无,例)	5/39	46/93	χ²=7.430	0.006
BMI(kg/m²)	25.37±2.03	26.74±2.45	t=-3.361	0.001
FBG(mmol/L)	5.57±0.79	5.68±1.00	t=-0.629	0.530
TC(mmol/L)	5.13±0.77	5.28±0.91	t=-1.032	0.304
TG(mmol/L)	1.88(1.48-2.25)	1.93(1.54-2.47)	Z=1.445	0.148
LDL-C(mmol/L)	2.53±0.84	2.93±1.097	t=-2.217	0.028
HDL-C(mmol/L)	1.18±0.47	0.99±0.37	t=2.415	0.019
ALT(U/L)	26.32±9.42	31.12±12.67	t=-2.318	0.022
AST(U/L)	26.98±9.33	38.25±8.07	t=-7.770	0.000
UA(μmol/L)	290.50(234.00-323.50)	297.00(245.00-367.50)	Z=1.081	0.280
PLT(×10⁹/L)	233.59±59.02	200.22±48.33	t=3.777	0.000
FIB-4	1.103(0.743-1.538)	1.908(1.528-2.357)	Z=7.344	0.000

影响因素	B	SE	Wald χ²值	P值	OR值	95%CI
影响因素	B	SE	Wald χ²值	P值	OR值	下限	上限
年龄	0.087	0.039	5.077	0.024	1.091	1.011	1.177
性别	1.298	0.644	4.059	0.044	3.660	1.036	12.933
吸烟史	0.390	0.593	0.431	0.512	1.476	0.461	4.724
糖尿病史	0.582	0.782	0.554	0.457	1.790	0.386	8.297
BMI	0.294	0.149	3.911	0.048	1.342	1.003	1.796
LDL-C	0.104	0.312	0.110	0.740	1.109	0.061	2.046
HDL-C	-1.389	0.701	3.929	0.047	0.249	0.063	0.985
AST	0.186	0.049	14.435	0.000	1.205	1.094	1.327
FIB-4	1.425	0.689	4.280	0.039	4.157	1.078	16.031

影响因素	B	SE	Wald χ²值	P值	OR值	95%CI
影响因素	B	SE	Wald χ²值	P值	OR值	下限	上限
年龄	0.087	0.039	5.077	0.024	1.091	1.011	1.177
性别	1.298	0.644	4.059	0.044	3.660	1.036	12.933
吸烟史	0.390	0.593	0.431	0.512	1.476	0.461	4.724
糖尿病史	0.582	0.782	0.554	0.457	1.790	0.386	8.297
BMI	0.294	0.149	3.911	0.048	1.342	1.003	1.796
LDL-C	0.104	0.312	0.110	0.740	1.109	0.061	2.046
HDL-C	-1.389	0.701	3.929	0.047	0.249	0.063	0.985
AST	0.186	0.049	14.435	0.000	1.205	1.094	1.327
FIB-4	1.425	0.689	4.280	0.039	4.157	1.078	16.031