不同人体测量指标对代谢相关脂肪性肝病诊断价值的比较

摘要/Abstract

摘要： 目的评估传统人体测量指标与新型腹部肥胖指标与代谢相关脂肪性肝病(MAFLD)的相关性,并分析及比较两者的诊断价值。方法本研究为横断面研究,纳入人群为2021年1月1日至2024年9月15日于首都医科大学附属北京积水潭医院健康管理中心的体检者,通过医院健康体检数据库收集入选者的一般资料、病史、实验室检查及影像学检查结果等,根据是否检出MAFLD,分为MAFLD组和对照组,采用单因素检验、卡方检验、多因素logistic回归分析明确MAFLD的危险因素,采用受试者工作特征曲线(ROC)分析有统计学意义的因素对MAFLD的诊断价值并进行比较。结果共纳入2 118名受试者。MAFLD患病率24.22%,男性(32.72%)＞女性(11.83%),体质指数(BMI):正常组(4.76%)＜超重肥胖组(45.82%),组间比较差异有统计学意义(P<0.05)。传统指标[腰围(WC)、BMI、腰臀比(WHR)、腰高比(WHtR)]、新型指标[腹部体积指数(AVI)、身体圆度指数(BRI)、身体脂肪指数(BAI)、体形指数(ABSI)、锥度指数(C-index)、体质量调整腰围指数(WWI)]均与MAFLD的发生相关,其中,AVI、BRI、WC、WHtR、BMI的AUC值均＞0.80,能较好预测MAFLD的发生,表明新型指标与传统指标相比没有明显优势。但在新型指标中,腹部体积指数(AVI)表现出了最高的诊断价值[AUC=0.874(95％CI:0.859~0.890)],且针对女性人群的诊断价值[AUC=0.908(95％CI:0.881~0.935)]优于男性人群[AUC=0.839(95％CI:0.816~0.860)]。结论 AVI、BRI、WC、WHtR、BMI均能较好预测MAFLD的发生。其中,AVI、WC的诊断价值最高,此优势在女性人群中尤为显著。

关键词: 代谢相关脂肪性肝病, 人体测量指标, 诊断价值

Abstract: Objective To evaluate the correlations between traditional anthropometric indicators and new abdominal obesity indicators with metabolic-dysfunction-associated fatty liver disease (MAFLD), and to analyze and compare their diagnostic values. Methods This was a cross-sectional study. The included population was those who underwent physical examinations at the Health Management Center of Beijing Jishuitan Hospital, Capital Medical University from January 1, 2021 to September 15, 2024. General information, medical history, laboratory examination results and imaging examination results of the selected subjects were collected through the hospital′s health examination database. According to whether MAFLD was detected or not, the subjects were divided into the MAFLD group and the control group. Univariate tests (two independent sample t-tests, Mann-Whitney U tests), chi-square tests and multivariate logistic regression were used to analyze the risk factors for MAFLD. The receiver operating characteristic curve (ROC) was used to analyze and compare the diagnostic values of the significant factors for MAFLD. Results A total of 2 118 subjects were included. The prevalence rate of MAFLD was 24.22%, with that in men (32.72%) being higher than that in women (11.83%), and that in the normal body mass index (BMI) group (4.76%) being lower than that in the overweight and obese group (45.82%). The differences between groups were statistically significant (P<0.05). Traditional indicators [waist circumference (WC), BMI, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR)], and new indicators [abdominal volume index (AVI), body roundness index (BRI), body adiposity index (BAI), a body shape index (ABSI), conicity index (C-index),weight-adjusted waist index (WWI)] were all associated with the occurrence of MAFLD. Among them, the AUC values of AVI, BRI, WC, WHtR and BMI were all greater than 0.80, which had good predictive efficacy for MAFLD, indicating that the new indicators had no obvious advantages compared with the traditional indicators. However, among the new indicators, the abdominal volume index (AVI) showed the strongest diagnostic value [AUC=0.874 (95％CI:0.859~0.890)], and its value for the female population [AUC=0.908 (95％CI:0.881~0.935)] was better than that for the male population [AUC=0.839 (95％CI:0.816~0.860)]. Conclusion AVI, BRI, WC, WHtR and BMI can predict the occurrence of MAFLD fairly well. AVI and WC have the strongest diagnostic value, especially in the female population.

Key words: Metabolic dysfunction-associated fatty liver disease, Anthropometric indicators, Diagnostic values

张月霞, 王宇, 冯艳苹, 高岩. 不同人体测量指标对代谢相关脂肪性肝病诊断价值的比较[J]. 肝脏, 2026, 31(1): 75-80.

ZHANG Yue-xia, WANG Yu, FENG Yan-ping, GAO Yan. Comparison of the diagnostic values of different anthropometric indicators for metabolic dysfunction-associated fatty liver disease[J]. Chinese Hepatolgy, 2026, 31(1): 75-80.

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