| Background and objectiveLiving style, diet structure and more has changed in recent years, and non-alcoholic fatty liver disease (NAFLD) increasingly catches people’s attention because of its higher tendency caused by increased number of metabolism-associated diseases, such as obesity, type 2 diabetes mellitus, and dyslipidemia. People in the Unites States and other developed countries suffering from NAFLD account for 20%-30% and in China suffering from fatty liver account for about 15% of the total population, so fatty liver diseases become one of the three major liver diseases harmful to human health. Because of insufficient effective means and drugs for treatment of NAFLD currently, there is quite significant to find out the way of prevention and early intervention of NAFLD.Insulin resistance (IR) plays an important pathophysiological role in the formation of fatty liver from the pathogenesis aspect, but how to make accurate determination of IR status is complicated. For that determination, HOMA-IR is most widely used, but it is impossible to make regular test of insulin level in the regular physical examination and clinical practice, thus HOMA-IR is maximal restricted to use. A previous research shows that IR status significantly correlates with liver enzyme and dyslipidemia, which makes possible that to prevent fatty liver diseases make measurement of liver enzyme and dyslipidemia. According to the existing research done in China, blood uric and triglyceride is likely to have predictive value in the diagnosis of NAFLD, and the index of lipid analysis, as part of regular physical examination indexes, has been received consensus on its early prevention of cardiovascular and insulin resistance. Another index of lipoprotein ratio, especially triglyceride to high-density lipoprotein ratio, has greater advantage than single index, and has been proven to be an index for prevention of adult IR status, according to relevant references. However, there is still insufficient research related with fatty liver to prove that people suffering from fatty liver have more frequent dyslipidemia than those suffering from non-fatty liver, and that probably is correlated with triglyceride to high-density lipoprotein ratio.Analyze the risk factors of the non-alcoholic fatty liver diseases and explore the diagnostic value of the triglyceride/high-density lipoprotein (TG/HDL-C) ratio and y-glutamyl transferase in the non-alcoholic fatty liver diseases.Methods335 cases received physical examination were enrolled and followed up for 3 years Their alanine aminotransferase, aspartate aminotransferase, y-glutamyl transferase, uric acid, lipid profile, fasting glucose were examined in baseline and during following up. The triglyceride(TG)/high-density lipoprotein (HDL-C) ratio was calculated by TG/HDL-C.Results(1) The level of basic body index,triglyceride, TG/HDL-C,y-glutamyl transferase were higher and the body mass index (BMI),blood pressure,total cholesterol,high density lipoprotein cholesterol, low density lipoprotein, uric acid,alanine aminotransferase, alkaline phosphatase had no difference in non-alcoholic fatty liver diseases group than in the normal group after 3 years(P<0.01).(2) TG/HDL-C and y-glutamyl transferase enzyme had higher sensitivity and specificity than triglyceride, blood pressure, total cholesterol,hige density lipoprotein, low density lipoprotein,alanine aminotransferase, aspartate aminotransferase,fasting glucose in the diagnosis of non-alcoholic fatty liver diseases. Area under curve of TG/HDL-C was 0.723 and 95% confidence limits was (0.632-0.813).Area under curve of GGT was 0.753 and 95% confidence limits was (0.661-0.846).There were significance in the diagnosis of non-alcoholic fatty liver diseases when TG/HDL-C were 1.3962 or y-glutamyl transferase were 28U/L.Conclusion(1)TG/HDL-C and y-glutamyl transferase can predict the occurrence of NAFLD.(2)TG/HDL-C and y-glutamyl transferase can be used as a reference index of early diagnosis of NAFLD. |
PDF Full Text Request