脂肪肝指数与非酒精性脂肪性肝病和冠状动脉粥样硬化性心脏病的相关性研究

背景：研究显示非酒精性脂肪性肝病（NAFLD）与心血管疾病关系密切，脂肪肝指数（FLI）在欧洲人群中可用于脂肪肝的预测。目的：探讨FLI在中国人群中与NAFLD和严重心血管疾病冠状动脉粥样硬化性心脏病（CAD）的相关性。方法：713例因高度疑似CAD而行冠状动脉造影的上海市本地居民纳入研究，并根据造影结果分为CAD组和非CAD组。其中574例根据腹部B超检查结果分为NAFLD组和非NAFLD组。以NAFLD或CAD为因变量，以包括FU在内的其他变量为自变量进行多因素Loostic回归分析。结果：NAFLD组FLI显著高于非NAFLD组（P〈0．01）；不同FLI级别组间（〈30、30～60和≥60）NAFLD患病率差异有统计学意义（P〈0．01）；经校正性别、年龄因素，FLI为NAFLD的危险因素之一（OR=1．038，95％CI：1．029～1．047，P=0．000），其他危险因素包括高血压史、糖尿病史和高血脂史。CAD与非CAD组间FLI以及不同FLI级别组间CAD患病率差异均无统计学意义；经校正年龄因素，AST和总胆固醇（TC）为CAD的危险因素，高密度脂蛋白（HDL）为CAD的保护因素，FLI与CAD之间无相关性（男性OR=0．996，95％CI：0．988-1．004，P=0．359；女性OR=0．995，95％CI：0．976～1．014，P=0．574）。结论：在中国人群中，FLI与NAFLD具有相关性，可用于NAFLD的筛选和预测；FLI与CAD无明显相关性，是否可用于CAD的预测有待进一步研究。

Correlation of Fatty Liver Index with Non-alcoholic Fatty Liver Disease and Coronary Atherosclerotic Heart Disease

Background： Recent studies showed that non-alcoholic fatty liver disease （NAFLD） was independently associated with increased risk of cardiovascular disease, and fatty liver index （FLI） was a predictor of hepatic steatosis in Caucasian population. Aims ： To analyze the correlation of FLI with NAFLD and coronary atherosclerotic heart disease （CAD） , a severe cardiovascular disease in Chinese population. Methods： Seven hundred and thirteen Shanghai inhabitants undergoing coronary arteriography for highly suspected CAD were enrolled, and were classified into CAD and non-CAD groups according to the results of arteriography. Of them, 574 individuals were divided into NAFLD and non-NAFLD groups according to abdominal B-type ultrasonography. Using NAFLD or CAD as dependent variable, and multiple other variables including FLI as independent variables, a multivariate Logistic regression analysis was conducted. Results： FLI in NAFLD group was significantly higher than that in non-NAFLD group （P 〈 0.01 ）. Prevalence of NAFLD between FLI 〈 30, 30-60 and 1〉60 groups were significantly different （P 〈 0.01 ）. After adjusting for gender and age, FLI （ OR = 1. 038, 95% CI： 1. 029-1. 047, P = 0.000） and history of hypertension, diabetes and hyperlipidemia were risk factors for NAFLD. By contrast, difference in FLI between CAD and non-CAD groups and difference in prevalence of CAD between FLI 〈 30, 30-60 and ≥ 60 groups were insignificant. After adjusting for age, AST and total cholesterol （TC） were risk factors for CAD, while high density lipoprotein （HDL） was protective factor for CAD. FLI was not correlated with CAD （ male ： OR = 0.996, 95% CI ： 0. 988-1. 004, P = 0. 359 ; female ： OR = 0. 995, 95% CI ： 0. 976-1. 014, P = 0. 574）. Conclusions： FLI is correlated with NAFLD and can be used for screening and predicting NAFLD in Chinese population. However, no significant association is existed between FLI and CAD. Whether FLI can be used as a predictor for CAD needs to be investigated in further study.