血清尿酸肌酐比值与TyG联合模型对老年2型糖尿病合并非酒精性脂肪性肝病的预测作用
DOI:
作者:
作者单位:

1.苏州大学附属第一医院老年医学科;2.苏州大学附属第一医院消化内科

作者简介:

通讯作者:

中图分类号:

基金项目:

1、国家自然科学基金青年基金项目:Dyrk1b 促进 STAT3 的磷酸化在星形胶质细胞炎症激活所致神经损伤中的作用机制研究;课题号81901262 2、江苏省老年健康科研项目;课题号LR2021010


Application of serum uric acid-creatinine ratio and triglyceride-glucose index in predicting elderly type 2 diabetes mellitus patients with nonalcoholic fatty liver disease
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的 探讨血清尿酸肌酐比值(SUA/Scr)与甘油三酯葡萄糖乘积指数(TyG)对老年2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的预测价值。方法 回顾性分析2021年1月至2022年6月期间于苏州大学附属第一医院老年医学科就诊的年龄均大于60岁的300例2型糖尿病的临床资料,按照有无NAFLD分为T2DM合并NAFLD组(n=146)和单纯T2DM组(n=154)。采用SPSS 25.0软件进行统计学分析。计量资料两组间比较采用独立样本t检验或Mann?Whitney U检验。计数资料两组间比较采用χ2 检验。采用Logistic 回归分析SUA/Scr、TyG与老年T2DM合并NAFLD的关系,采用受试者工作特征曲线(ROC曲线)下面积(AUC)评估SUA/Scr、TyG及SUA/Scr联合TyG对老年T2DM合并NAFLD的预测价值。结果 老年T2DM合并NAFLD组的BMI、收缩压、舒张压、空腹C肽、FPG、FINS、ALT、AST、GGT、LDL-C、TG、TC、SUA、TyG、SUA/Scr均高于单纯T2DM组(p值均<0.05),T2DM合并NAFLD组的HDL-C、Scr、CysC均低于单纯T2DM组(p值均<0.05),两组在性别、ALB、LDH、α-羟丁酸脱氢酶、HbA1c、BUN、TBil的差异均无统计学意义(p值均>0.05)。Logistic分析显示TyG(OR=3.524,95%CI:2.276-5.457,p<0.001)和SUA/Scr(OR=1.725,95%CI:1.415-2.104,p<0.001)为老年T2DM合并NAFLD的独立危险因素。ROC曲线显示,TyG预测老年T2DM合并NAFLD的AUC为0.732(95%CI:0.676-0.789),最佳截断点为7.24,敏感度和特异度分别为80.8%和58.4%。SUA/Scr预测老年T2DM合并NAFLD的AUC为0.734(95%CI:0.678-0.789),最佳截断点5.44,敏感度和特异度分别为58.9%和75.3%。两者联合预测老年T2DM合并NAFLD的AUC为0.800(95%CI:0.750-0.849),敏感度和特异度分别为71.9%和77.9%。结论 SUA/Scr和TyG对预测老年T2DM合并NAFLD的发生具有一定的价值,且联合检测的预测价值更高。

    Abstract:

    objective To investigate the predictive value of serum uric acid creatinine ratio (SUA/Scr) and triglyceride-glucose index (TyG) in elderly patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease(NAFLD). Methods A total of 300 patients with T2DM admitted to our hospital from January 2021 to June 2022 were divided into T2DM alone group (n=154) and NAFLD group (n=146) according to whether they had NAFLD. Logistic regression was used to analyze the relationship between SUA/Scr and TyG with NAFLD in elderly T2DM patients. The area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive value of SUA/Scr, TyG and SUA/Scr combined with TyG in elderly T2DM patients with NAFLD. Results The BMI, systolic blood pressure, diastolic blood pressure, fasting C-peptide, FPG, FINS, ALT, AST, GGT, LDL-C, TG, TC, SUA, TyG and SUA/Scr in T2DM group were higher than those in T2DM group alone (all p<0.05). The levels of HDL-C, Scr and CysC in T2DM combined with NAFLD group were lower than those in T2DM alone group (all p<0.05). There were no significant differences in gender, ALB, LDH, α-HBDH, HbA1c, BUN and TBil between the two groups (all p >0.05). The logistic regression analysis showed that TyG (odds ratio [OR]=3.524, 95% confidence interval[CI] 2.276-5.457, p<0.001) and SUA/Scr (OR=1.725,95% CI: 1.415-2.104, p<0.001) were independent risk factors for elderly T2DM patients with NAFLD. The AUC of TyG for predicting NAFLD in elderly T2DM patients was 0.732(95%CI:0.676-0.789),at the optimal cut-off point of 7.24. The sensitivity and specificity were 80.8% and 58.4%, respectively. The AUC of SUA/Scr for predicting NAFLD in elderly T2DM patients was 0.734(95%CI:0.678-0.789), at the optimal cut-off point of 5.44. The sensitivity and specificity were 58.9% and 75.3%, respectively. SUA/Scr combined with TyG had an AUC of 0.800(95%CI:0.750-0.849),a sensitivity of 71.9%,a specificity of 77.9%. Conclusion SUA/Scr and TyG have certain value in predicting the occurrence of NAFLD in elderly patients with T2DM, and the combined detection has higher predictive value.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2022-11-14
  • 最后修改日期:2022-12-20
  • 录用日期:2023-05-23
  • 在线发布日期:
  • 出版日期: