Clinical Study On Relationship Of Hepatic Controlled Attenuation Parameter With Metabolic Syndrome

Part ? Correlation Research between Controlled Attenuation Parameter and Metabolic Syndrome Objective: To investigate the correlation between hepatic controlled attenuation parameter(CAP)and the number of metabolic syndrome(MetS)components and MetS components.Methods: We included participants underwent physical examination from the People's Hospital of Kunshan Jinxi and patients from the digestive department of Xinhua Hospital affiliated to School of Medicine of Shanghai Jiaotong University.We explored the correlation between CAP and the number of MetS components and MetS components.Then we assessed the proportions of MetS and its components in different CAP levels(< 238dB/m?238 ~ 258 dB/m?259 ~ 291 dB/m?? 292 dB/m).Logistic regression was done to assess the risk of MetS in different CAP levels.Results: 2461 subjects were enrolled,included 1031(41.9%)male and 1430(58.1%)female,with median age 58(50 ~ 62)y.CAP positively correlated with the number of MetS components(r = 0.309,P < 0.001).CAP significantly positively correlated with BMI,WC,SBP,DBP,TG and FPG,and negatively correlated with HDL-C.Among them,BMI had the biggest correlation coefficient correlated with CAP(r =0.435,P < 0.001).The proportions of MetS increased as CAP level elevated(P <0.001).Logistic regression showed that after adjusting for gender and age,ORs(95%CI)of 238 ~ 258 dB/m?259 ~ 291 dB/m and ? 292 dB/m were 1.784(1.369 ~2.325),2.936(2.292 ~ 3.760)and 4.363(3.435 ~ 5.543),with P < 0.05.We further grouped the subjects by BMI value(BMI < 25kg/m2 and BMI ? 25kg/m2).After adjusting for gender and age,the ORs(95%CI)of BMI < 25kg/m2 were 1.518(1.053 ~ 2.190),2.394(1.671 ~ 3.430)and 2.826(1.897 ~ 4.211),while the ORs(95%CI)of BMI ? 25kg/m2 were 1.575(1.008 ~ 2.462),1.900(1.288 ~ 2.801)and2.359(1.656 ~ 3.360),respectively.Conclusion: CAP is closely related to MetS and its components,so it can reflect the metabolic disorder status to some extent.CAP can be used to assess the risk of MetS.The risk of MetS increases as the CAP level elevated.Individuals with normal body weight have higher risk of MetS than obese ones.Part ? Prospective Study of Controlled Attenuation Parameter Predicting Metabolic SyndromeObjective: To investigate the effect of CAP and CAP changes on the development and regression of Met S,and explore the predicting effects of CAP on Met S.Methods: We included participants underwent physical examination from the People's Hospital of Kunshan Jinxi and patients from the digestive department of Xinhua Hospital affiliated to School of Medicine of Shanghai Jiaotong University.Characteristics at baseline and follow-up were compared.All the participants were divided into four groups according to the outcomes of Met S,and baseline CAP value,CAP change and percentage of CAP change were compared between groups.Non-Met S subjects at baseline were picked out,and the proportions of development of Met S were compared grouped by baseline CAP value,CAP change and percentage of CAP change.COX regression model was done to analyses baseline CAP,CAP change and percentage of CAP change predicting Met S.Results: 344 subjects were enrolled The proportion of Met S was lower at follow-up and the number of Met S components decreased.Baseline CAP value was higher in Development of Met S.The proportion of Met S of CAP ? 238 d B/m was higher than that of CAP < 238 d B/m(?~2 = 15.549,P < 0.001).Percentage of CAP change >25.0% group had higher proportion of Met S than ? 25.0% group(?~2 = 6.964,P =0.008).However,there were no significant difference between CAP change groups(?~2 = 0.557,P = 0.455).The RRs(95% CI)of CAP ? 238 d B/m,CAP change > 30dB/m and percentage of CAP > 25.0% were 4.683(1.973 ~ 11.115),1.269(0.682 ~2.362)and 2.561(1.278 ~ 5.133),respectively.COX regression analysis showed that unadjusted and adjusted HRs(95%CI)were [4.533(1.824 ~ 11.267),P < 0.05] and[3.337(1.163 ~ 9.569),P < 0.05] for baseline CAP value,[2.058(0.963 ~ 4.398),P= 0.063] and [7.732(2.453 ~ 24.366),P < 0.05] for CAP change > 30 d B/m,[2.433(1.121 ~ 5.281),P = 0.025] and [11.656(3.329 ~ 40.813),P < 0.001] for percentage of CAP change > 25.0%,respectively.Confounding factors included gender,age,Baseline BMI,WC,FPG,TG and HDL-C.Baseline CAP value was adjusted for CAP change and percentage of CAP change predicting Met S.Conclusion: The baseline CAP values,CAP changes and percentage of CAP change were closely related to the development and regression of Met S.Baseline CAP,CAP change and percentage of CAP change have predictive effect on Met S.The predicted value of CAP change and percentage of CAP change is greater than that of baseline CAP value.Physicians should suggest high risk populations to complete related examines to screen for Met S related diseases and carry out intervention early to improve their prognosis.