【摘要】 目的 探索甘油三酯-葡萄糖(triglyceride-glucose, TyG)指数与肥胖指标对≥60岁老年人群非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)患病风险的影响，为NAFLD的早期预防提供依据。方法 2022年采取分层随机整群抽样法选取南京95 932名体检老年人进行问卷调查、体格检查和实验室检查。采用logistic回归分析TyG与多项肥胖指标对NAFLD患病风险的影响，并分析TyG与各肥胖指标分别联合后对NAFLD的交互作用；采用受试者工作特征曲线评估TyG及其联合肥胖指标的诊断价值。结果 本研究中NAFLD占39.66%。调整混杂因素后，logistic回归分析结果显示，随着TyG和肥胖指标BMI、中国人内脏脂肪指数和脂质蓄积指数的增加，NAFLD患病风险均上升，OR值分别为1.86(1.80～1.93)、3.69 (3.57～3.80)、3.66 (3.54～3.79)和3.28 (3.17～3.39)(均P<0.001)。交互作用结果显示，与TyG和肥胖指标均为低水平相比，其中之一或二者皆为高水平，NAFLD风险均增加，且二者存在协同作用。TyG联合各肥胖指标对NAFLD患病风险的诊断能力高于单一指标TyG。结论 老年人群NAFLD患病风险随TyG和肥胖指标水平的升高而增加，且具有联合效应。TyG联合BMI可能是老年人群NAFLD早期筛查的简单且高效的工具。更多还原

【Abstract】 Objective To explore the impact of the triglyceride-glucose index(TyG) and obesity indicators on the risk of non-alcoholic fatty liver disease(NAFLD) among participants aged ≥60 years, so as to provide evidence for the early prevention of NAFLD.Methods A stratified random cluster sampling method was used to select 95 932 elderly individuals in 2022 in Nanjing. These individuals underwent questionnaires, physical examinations, and laboratory tests. A logistic regression model was used to analyze the effects of the TyG and multiple obesity indicators on the risk of NAFLD, followed by the interaction analysis between TyG and each obesity indicator. The diagnostic value of the TyG and its combination with obesity indicators was assessed using receiver operating characteristic curves.Results In the study, the prevalence of NAFLD was 39.66%. After adjusting for confounding factors, logistic regression analysis showed that as the increase of TyG and obesity indicators, including BMI, Chinese visceral adiposity index, and lipid accumulation product, the risk of NAFLD in the elderly increased, with odds ratios of 1.86(1.80-1.93), 3.69(3.57-3.80), 3.66(3.54-3.79), and 3.28(3.17-3.39), respectively(P<0.001). Interaction analysis revealed that compared to low levels of both the TyG and obesity indicator, one variable at a high level or both at high levels increased the risk of NAFLD, indicating a synergistic effect. The diagnostic ability of the TyG combined with obesity indicators for NAFLD risk was higher than that of the TyG alone. Conclusion The risk of NAFLD in individuals aged ≥60 years increases with higher levels of the TyG and obesity indicators, and they have a combined effect on NAFLD risk. TyG combined with BMI may be a simple and efficient tool for the early screening of NAFLD in elderly people.更多还原