Dose-response relationship between ratio of triglyceride to high-density lipoprotein cholesterol based on body mass index classification and risk of nonalcoholic fatty liver disease
KANG Xiaoping1* HE Jian’gen2* GUO Xiuhua3 WU Liang2 ZHANG Xuesong1
1.Academy Office, Beijing Xiaotangshan Hospital, Beijing 102211, China；
2.Department of Sports Rehabilitation, Beijing Xiaotangshan Hospital, Beijing 102211, China；
3.School of Public Health, Capital Medical University, Beijing 100069, China
Abstract：Objective To explore the dose-response relationship between the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) and the risk of nonalcoholic fatty liver disease (NAFLD) in non-overweight and overweight people. Methods A total of 6495 physical examination subjects who participated in the Beijing Health Management Cohort (Beijing Xiaotangshan Hospital, Beijing Physical Examination Center, etc.) from January 2012 to December 2016 were selected as the research subjects. According to their body mass index, they were divided into non-overweight population (4473 people) and overweight population (2022 people). The influence of TG/HDL-C on the incidence of NAFLD in different population was analyzed. Results The incidence of NAFLD was 18.37%, including 10.08% in non-overweight population and 36.70% in overweight population. After adjusting for confounding factors, TG/HDL-C was statistically associated with the risk of NAFLD among different populations (OR = 1.84, 95%CI: 1.64-2.06). Restricted cubic spline analysis showed that there was a linear dose-response relationship between the TG/HDL-C ratio and the risk of NAFLD (linear test, P < 0.0001). Moreover, in non-overweight population, when TG/HDL-C ratio ＜ 1 might also increase the risk of NAFLD. Conclusion TG/HDL-C ratio has a great influence on NAFLD, and the change of TG/HDL-C ratio should be monitored.
康晓平1* 何件根2* 郭秀花3 武亮2 张雪松1. 基于体重指数分类的三酰甘油/高密度脂蛋白胆固醇比值与非酒精性脂肪肝发病风险的剂量反应关系[J]. 中国医药导报, 2021, 18(4): 98-102.
KANG Xiaoping1* HE Jian’gen2* GUO Xiuhua3 WU Liang2 ZHANG Xuesong1. Dose-response relationship between ratio of triglyceride to high-density lipoprotein cholesterol based on body mass index classification and risk of nonalcoholic fatty liver disease. 中国医药导报, 2021, 18(4): 98-102.
[1] 中华医学会肝病学分会脂肪肝和酒精性肝病学组，中国医师协会脂肪性肝病专家委员会.非酒精性脂肪性肝病防治指南（2018年更新版）[J].临床肝胆病杂志，2018， 34（5）：947-957.
[2] Zhou F，Zhou J，Wang W，et al. Unexpected Rapid Increase in the Burden of NAFLD in China From 2008 to 2018： A Systematic Review and Meta-Analysis. Hepatology，2019，70（4）：1119-1133.
[3] 宋清莲，袁贝贝，刘京京，等.非酒精性脂肪肝相关慢性肾病发病机制进展[J].临床医学进展，2019，9（9）：1073-1079.
[4] 古丽斯亚·海力力，姚华，王淑霞，等.乌鲁木齐市某区全民体检人群代谢综合征组分聚集性与非酒精性脂肪肝关系[J].中华疾病控制杂志，2019，23（11）：1358-1363.
[5] 雷蕾，环奕，孙素娟，等.新型选择性过氧化物酶体增殖体γ调节药YR4-42改善2型糖尿病KKAy小鼠的代谢异常和非酒精性脂肪肝的研究[J].中国临床药理学杂志，2020，36（11）：1544-1548.
[6] 杨艳红，霍经纬.非酒精性脂肪肝纤维化评分、铁蛋白与冠心病的关系探讨[J].中西医结合心脑血管病杂志，2020， 18（9）：1503-1504.
[7] 吴晓清.脑梗死合并非酒精性脂肪肝患者66例临床分析[J].心脑血管病防治，2014（1）：68-70.
[8] 钱雪薇，张洁.非肥胖非酒精性脂肪肝患者的流行情况、临床特点及危险因素[J].临床医药文献电子杂志，2018， 5（6）：181-182.
[9] Kim-Dorner SJ，Deuster PA，Zeno SA，et al. Should triglycerides and the triglycerides to high-density lipoprotein cholesterol ratio be used as surrogates for insulin resistance [J] Metabolism，2010，59（2）：299-304.
[10] 中华人民共和国卫生部疾病控制司.中国成人超重和肥胖症预防控制指南[M].北京：人民卫生出版社，2006．
[11] 中国营养学会.中国居民膳食营养素参考摄入量[M].北京：中国轻工业出版社，2013．
[12] World Health Organization. Global strategy on diet，physical activity and Realth，2004 [J]. Food Nutr Bull，2004， 25（3）：292-302.
[13] 中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南（2016年修订版）[J].中华心血管病杂志，2016，44（10）：833-853.
[14] 国际内分泌专家小组.2017国际专家组建议：生活方式干预预防和管理代谢综合征[J]. Nutr Rev，2017，75（5）：307-326.
[15] 中华医学会.高血压基层诊疗指南（2019）[J].中华全科医师杂志，2019，1（4）：301-313.
[16] American Diabetes Association. Standards of Medical Care in Diabetes-2020 [J]. Diabetes Care，2020，43（1）：1-212.
[17] Budd J，Cusi K. Non-Alcoholic Fatty Liver Disease：What Does the Primary Care Physician Need to Know [J]. Am J Med，2020，133（5）：536-543.
[18] Wang XJ，Malhi H. Nonalcoholic Fatty Liver Disease [J]. Ann Intern Med，2018，169（9）：ITC65-ITC80.
[19] Fargion S，Porzio M，Fracanzani AL. Nonalcoholic fatty liver disease and vascular disease：State-of-the-art [J]. World J Gastroenterol，2014，20（37）：13306-13324.
[20] Adams LA，Anstee QM，Tilg H，et al. Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases [J]. Gut，2017，66（6）：1138-1153.
[21] 林仿，任跃忠，褚建平，等.甘油三酯与高密度脂蛋白胆固醇比值和谷氨酰转移酶对非酒精性脂肪肝的预测价值[J].中华全科医学，2017，15（7）：1175-1179.
[22] Anjani K，Lhomme M，Sokolovska N，et al. Circulating phospholipid profiling identifies portal contribution to NASH signature in obesity [J]. J Hepatol，2014，62（4）：905-912.
[23] Ress C，Kaser S. Mechanisms of intrahepatic triglyceride accumulation [J]. World J Gastroenterol，2016，22（4）：1664-1673.
[24] 张力元，盛夏，胡平方，等.血清高密度脂蛋白胆固醇在非酒精性脂肪性肝病风险评估中的价值[J].中华消化杂志，2019，39（5）：317-321.
[25] 周谦，苏娟，季梦遥.非酒精性脂肪性肝病的治疗研究进展[J].中国医药导报，2020，17（6）：26-29.
[26] Sun DQ，Wu SJ，Liu WY，et al. Association of low-density lipoprotein cholesterol within the normal range and NAFLD in the non-overweight Chinese population：a cross-sectional and longitudinal study [J]. Bmj Open，6（12）：e013781.
2021, Vol. 18 
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