三酰甘油-总胆固醇-体重指数与2型糖尿病合并代谢功能障碍相关脂肪性肝病的关联OA
Association between triglycerides-total cholesterol-body mass index composite index and metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes mellitus
目的:探究三酰甘油 总胆固醇 体重指数(triglycerides-total cholesterol-body mass index,TCBI)与2 型糖尿病(T2DM)患者合并代谢功能障碍相关脂肪性肝病(metabolic dysfunction-associated steatotic liver disease,MASLD)的相关性及预测价值.方法:纳入2018 年12 月至2025 年2 月在江苏大学附属医院内分泌代谢科就诊的T2DM 患者1 361 例,根据诊断标准将其分为 MASLD 组(n=836)和对照组(n=525),比较两组间临床资料及 TCBI 水平的差异.根据 TCBI 四分位数将受试者进一步分为 Q1 组(TCBI<1 361.6,n=340)、Q2 组(1 361.6≤TCBI<2 088.9,n=341)、Q3 组(2 088.9≤TCBI<3 398.8,n=340)、Q4 组(TCBI≥3 398.8,n=340);应用二分类 Logistic 回归模型分析TCBI 与 T2DM 患者合并 MASLD 的相关性.采用受试者工作特征(ROC)曲线分析 TCBI 的预测效能.结果:与对照组相比,MASLD 组 TCBI 水平明显升高(P<0.01).随着 TCBI 四分位数增加,体重指数、腰围呈递增趋势(P 均<0.01),而高密度脂蛋白胆固醇水平呈递减趋势(P<0.01),男性比例逐渐增加(P<0.01).二分类 Logistic 回归分析显示,校正混杂因素后,与 Q1 组相比,Q2 组、Q3 组、Q4 组人群发生 MASLD 的 OR 值(95%CI)分别为 2.68(1.79～4.03)、4.58(2.92～7.18)和 6.30(3.76～10.56),提示 TCBI 是 T2DM 患者发生 MASLD 的独立危险因素.ROC 曲线分析结果显示,TCBI 预测 T2DM 患者合并 MASLD 的曲线下面积为 0.781(95%CI:0.756～0.807,P<0.01),灵敏度为 0.839,特异度为 0.657.结论:TCBI 与 T2DM 患者合并 MASLD 显著相关,且为其独立危险因素.TCBI 对T2DM 患者合并 MASLD 具有预测价值.
Objective:To investigate the association between triglycerides-total cholesterol-body mass index(TCBI)and metabolic dysfunction-associated steatotic liver disease(MASLD)in patients with type 2 diabetes mellitus(T2DM)and evaluate its predictive value for MASLD.Methods:A total of 1 361 T2DM patients who were treated in the Department of Endocrinology and Metabolism at the Affiliated Hospital of Jiangsu University from December 2018 to February 2025 were included in this study.Participants were classified into MASLD(n=836)and control(n=525)groups according to diagnostic criteria.Clinical characteristics and TCBI levels were compared between groups.Participants were further stratified into four groups based on TCBI index,including Q1(TCBI<1 361.6,n=340),Q2(1 361.6≤TCBI<2 088.9,n=341),Q3(2 088.9≤TCBI<3 398.8,n=340),and Q4(TCBI≥3 398.8,n=340).Binary logistic regression models were used to examine the independent association between TCBI and MASLD,and receiver operating characteristic(ROC)curves analysis was used to assess the predictive performance of TCBI.Results:Compared with the control group,patients in the MASLD group had a higher TCBI level(P<0.01).With the increase of TCBI quartiles,body mass index and waist circumference showed an increasing trend(P<0.01),while the level of high-density lipoprotein cholesterol presented a decreasing trend(P<0.01),and the proportion of males gradually increased(P<0.05).After adjusting for confounders,compared with Q1,the odds ratios(95%CI)for MASLD in Q2,Q3,and Q4 were 2.68(1.79-4.03),4.58(2.92-7.18)and 6.30(3.76-10.56),respectively,indicating that TCBI was an independent risk factor for MASLD in T2DM.The area under the ROC curve of TCBI was 0.781(95%CI:0.756-0.807,P<0.01),the sensitivity was 0.839,and the specificity was 0.657.Conclusion:TCBI is independently and significantly associated with MASLD in patients with T2DM.TCBI has predictive value for MASLD in patients with T2DM.
张秀慧;吴文韬;邓霞;吴旭楠;贾珏;赵丽;王东;杨玲;袁国跃
江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001江苏大学附属医院内分泌代谢科,江苏 镇江 212001||江苏大学内分泌代谢病研究院,江苏 镇江 212001
医药卫生
三酰甘油-总胆固醇-体重指数2型糖尿病代谢功能障碍相关脂肪性肝病胰岛素抵抗
triglycerides-total cholesterol-body mass indextype 2 diabetes mellitusmetabolic dysfunction-associated steatotic liver diseaseinsulin resistance
《江苏大学学报（医学版）》 2026 (3)
223-229,7
江苏省社会发展重点研发项目(BE2018692)
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