Characteristics and correlation analysis of clinical indexes in patients with different degrees of lean non-alcoholic fatty liver disease

Abstract

Abstract: Objective To analyze the characteristics of clinical indexes of leannon-alcoholic fatty liver disease (NAFLD) patients with different degrees of B-ultrasound, and to explore the differences among their clinical indicators. Methods From December 2019 to December 2022, 336 patients with lean NAFLD were selected from the outpatient department, inpatient department, and physical examination center of the Department of Gastroenterology in Putuo District Central Hospital, Shanghai. The patients were divided into mild group (n=119), moderate group (n=190) and severe group (n=27) according to the results of B-ultrasound and liver ultrasound grading diagnostic criteria.At the same time, we collect the clinical laboratory data of each patient, including B-ultrasound, blood routine, liver and kidney function, blood lipids, tumor indicators and other common clinical data for analysis. SPSS statistical software (version 26.0) was used to analyze the correlation of these indicators. Methods There were significant differences in the distribution of HCT(P=0.017),RDW(P=0.01),BASO(P=0.026),AKP(P=0.002),γ-GT(P<0.001),ALT(P<0.001),AST(P<0.001),FPG(P<0.001),LDL-C(P=0.006),TC(P=0.006),TG(P<0.001),APOB(P<0.001),CEA(P=0.002),AFP(P<0.001),CA211(P=0.017), and NSE(P=0.004) in NALFD patients with different degrees of B-ultrasound, and the differences were only statistically significant in mild and moderate groups. The distribution of other indicators was not statistically significant (P> 0.05). There was a significant correlation between the severity of B-ultrasound and RDW(r=0.159,P=0.004)、BASO(r=0.141,P=0.01)、AKP(r=0.145,P=0.008)、γ-GT(r=0.194,P<0.001)、ALT(r=0.236,P<0.001)、AST(r=0.215,P<0.001)、FPG(r=0.202,P<0.001)、LDL-C(r=0.149,P=0.006)、TC(r=0.158,P=0.004)、TG(r=0.202,P<0.001)、APOB(r=0.169,P=0.002)、CEA(r=0.125,P=0.022)、AFP(r=0.209,P=0.001)、CA211(r=0.152,P=0.005) and NSE(r=0.169,P=0.002) in patients with lean NALFD. The correlation of other indexes was not statistically significant (P>0.05). Conclusion Compared with mild lean NALFD patients, the laboratory indexes of moderate NAFLD patients are higher. These experimental indicators combined with B-ultrasonic grades can be used as an auxiliary tool for the diagnosis of the severity of mild lean NAFLD.

Key words: Lean NAFLD, B-ultrasonic Grading, Clinical Features

SUN Pei-qi, YUAN Yi-fu, SHEN Hong-quan, LIU Qin-yi, JIANG Yuan-ye. Characteristics and correlation analysis of clinical indexes in patients with different degrees of lean non-alcoholic fatty liver disease[J]. Chinese Hepatolgy, 2025, 30(1): 83-86.

References

[1] TangA, Ng CH, Phang PH, et al. Comparative burden of metabolic dysfunction in LeanNAFLD vs Non-lean NAFLD-a systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol,2023,21(7):1750-1760.e12.
[2] NabiO, Lapidus N, Boursier J, et al. Lean individuals with NAFLD have more severe liver disease and poorer clinical outcomes (NASH-CO Study)[J]. Hepatology,2023,78(1):272-283.
[3] WangAY, Dhaliwal J, Mouzaki M. Lean non-alcoholic fatty liver disease[J]. Clin Nutr,2019,38(3):975-981.
[4] VanWagnerLB, Armstrong MJ. Lean NAFLD: a not so benign condition?[J]. Hepatol Commun,2018,2(1):5-8.
[5] HagstromH, Nasr P, Ekstedt M, et al. Risk for development of severe liver disease in lean patients with nonalcoholic fatty liver disease:a long-term follow-up study[J]. Hepatol Commun,2018,2:48-57.
[6] ChooiYC,Ding C,Magkos F.The epidemiology of obesity[J].Metabolism,2019, 92: 6-10
[7] 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, 范建高等. 非酒精性脂肪性肝病防治指南(2018年更新版)[J]. 实用肝脏病杂志, 2018,21(02):30-39.
[8] FriedmanSL, Neuschwander-Tetri BA, Rinella M, et al. Mechanisms of NAFLD development and therapeutic strategies[J]. Nat Med,2018,24(7):908-922.
[9] SanyalAJ. Past, present and future perspectives in nonalcoholic fatty liver disease[J]. Nat Rev Gastroenterol Hepatol,2019,16(6):377-386.
[10] AslamH, Oza F, Ahmed K, et al. The role of red cell distribution width as a prognostic marker in chronic liver disease: a literature review[J]. Int J Mol Sci,2023,24(4):3487.
[11] KimHM, Kim BS, Cho YK, et al. Elevated red cell distribution width is associated with advanced fibrosis in NAFLD[J]. Clin Mol Hepatol. 2013,19(3):258-265.
[12] DoganS, Celikbilek M, Zararsiz G, et al. Red blood cell distribution width as a non-invasive marker for the assessment of inflammation in non-alcoholic steatohepatitis[J]. Hepatogastroenterology,2015,62(138):393-398.
[13] MichalakA, Guz M, Kozicka J, et al. Red blood cell distribution width derivatives in alcohol-related liver cirrhosis and metabolic-associated fatty liver disease[J]. World J Gastroenterol. 2022,28(38):5636-5647.
[14] SelenES, Choi J, Wolfgang MJ. Discordant hepatic fatty acid oxidation and triglyceride hydrolysis leads to liver disease[J]. JCI Insight. 2021,6(2):e135626.
[15] Pradhan-SunddT, Vats R, Russell JO, et al. Dys-regulated bile transporters and impaired tight junctions during chronic liver injury in mice[J]. Gastroenterology,2018,155(4):1218-1232.e24.
[16] NewsomePN, Cramb R, Davison SM, et al. Guidelines on the management of abnormal liver blood tests[J]. Gut,2018,67(1):6-19.
[17] PowellEE, Wong VW, Rinella M. Non-alcoholic fatty liver disease[J]. Lancet,2021,397(10290):2212-2224.
[18] ZhouJH, Cai JJ, She ZG, Li HL. Noninvasive evaluation of nonalcoholic fatty liver disease: Current evidence and practice[J]. World J Gastroenterol,2019,25(11):1307-1326.