【摘要】 目的 本研究旨在探讨在中国非肥胖性人群中，GGT/HDL-C(γ-Glutamyl Transferase/High Density Lipids)比值与非酒精性脂肪肝(Non-alcoholic fatty liver disease, NAFLD)的关系。方法 于2015年4月至2017年8月在南平市第一医院体检中心以非选择性方式招募了267名病例和470名对照进行病例对照研究。采用结构化问卷调查法收集患者的资料，包括年龄、性别、生活情况、既往病史等。人体测量数据，包括体重、身高、收缩压、舒张压及血液生化指标。使用logistic回归模型来分析GGT/HDL-C比值与NAFLD之间的关系。使用RCS(restricted cubic splines)分析来评估GGT/HDL-C比值和NAFLD之间的非线性关系。构建ROC(receiver operating characteristic curve)曲线，评估GGT、HDL-C、GGT/HDL-C比值对NAFLD患病风险的预测价值。结果 调整协变量后的结果显示，GGT/HDL-C比值与NAFLD患病风险呈正相关(OR=1.03, 95%CI:1.02～1.04)且分层分析结果十分稳定。此外，我们通过RCS回归发现GGT/HDL-C比值与NAFLD的患病风险之间存在非线性关系，其中饱和阈值约为23.53 U/mmol。ROC分析结果显示，GGT/HDL-C比值在预测NAFLD患病风险方面的价值高于GGT和HDL-C。结论 本研究揭示了非肥胖中国人群中GGT/HDL-C比值与NAFLD患病风险之间呈现正非线性关系。当GGT/HDL-C比值小于23.53时，GGT/HDL-C比值与NAFLD密切相关。更多还原

【Abstract】 Objective To investigate the relationship between the GGT/HDL-C(γ-Glutamyl Transferase/High Density Lipids) ratio and NAFLD in non-obese Chinese adults. Methods This study was a case-control study that recruited 267 patients and 470 controls in the Affiliated Nanping First Hospital of Fujian Medical University in a non-selective manner, Apr 2015-Aug 2017. We used a structured questionnaire to collect patients’ data, including age, sex, living conditions, past medical history, etc. And anthropometric data, including weight, height, systolic blood pressure, diastolic blood pressure, and blood biochemical indicators, was also collected. The Logistic regression model was used to investigate the relationship between GGT/HDL-C ratio and NAFLD. The non-linear link between the GGT/HDL-C ratio and NAFLD was identified using RCS(restricted cubic splines) regression. ROC(receiver operating characteristic curve) curves were constructed to evaluate the predictive value of GGT, HDL-C, GGT/HDL-C ratio for the risk of developing NAFLD. Results After adjusting for the related confounding factors, the results showed that GGT/HDL-C ratio was positively associated with the risk of developing NAFLD(OR= 1.03, 95%CI 1.02–1.04). Moreover, the subgroup analysis demonstrated the robustness of our results. In addition, we also found a nonlinear relationship of the GGT/HDL-C ratio with the risk of developing NAFLD using the RCS regression, where the saturation threshold was about 23.53 U/mmol. ROC analysis results showed that the GGT/HDL-C ratio was increasingly valuable in predicting the risk of developing NAFLD, and was better than GGT and HDL-C. Conclusion The present study reveals a positive and non-linear relationship between the GGT/HDL-C ratio and NAFLD risk in a non-obese Chinese population. GGT/HDL-C ratio is strongly associated with NAFLD when GGT/HDL-C ratio is less than 23.53.更多还原