Logistic Regression Analysis Of The Correlative Factors Of NAFLD Based On Different Syndromes And Study Of Serum GIP In NAFLD

Objective:To systematically evaluate the therapeutic efficacy of traditional Chinese medicine (TCM) in the treatment of NAFLD. With the Logistic regression analysis, the correlative factors of different types of syndromes of NAFLD were explored, which consequently provides the scientific basis for the prevention and treatment of NAFLD. By analyzing the changing characteristics of the content of serum GIP on empty stomach among the patients and healthy people, the correlation between GIP and NAFLD and the diagnosis significance of GIP to NAFLD were explored.Methods:(1) With the standard literature retrieval, the conclusive and exclusive criteria were made. With the database such as PubMed, CNKI and CBM, the relative medical literature at home and abroad from 1969 to 2010 were collected. After selection, the TCM compound prescriptions to NAFLD and the components were recorded and the Meta analysis was made.(2) 306 cases of NAFLD and 96 cases of healthy people for physical checkup were collected. With the NAFLD questionnaire, the clinical epidemiological data of the NAFLD patients and the correlative information of the laboratory examination were collected. With the univariate and multivariate logistic regression analysis, the correlative factors of NAFLD were firstly explored.(3) With the ELISA method, the contents of serum GIP on empty stomach among 61 cases of NAFLD and 22 cases of healthy people for physica] checkup were tested and compared between the two groups. With the univariate logistic regression analysis, the correlation between GIP and NAFLD was firstly explored. With the ROC curve, the diagnosis significance of GIP to NAFLD was discussed.(4) With the univariate and multivariate logistic regression analysis, the correlative factors of the liver depression and spleen deficiency syndrome and the damp-heat accumulation syndrome of NAFLD were firstly explored. Based on the factors, the comprehensive treatment scheme was pointed out.Results:(1) The results of the Meta analysis of the binary variable indicated that OR=4.53,95%CI (3.52,5.84) and the test for overall effect showed that Z=11.68, P<0.00001. The results of the Meta analysis of the continuous variable indicated that the pooled odds ratio was 95%CI (0.64,0.86) and the Test for overall effect showed that Z=13.22, P<0.00001. (2) With the univariate and multivariate logistic regression analysis among the 306 cases of NAFLD and 96 cases of healthy people for physical checkup, the results indicated that BMI, edible oil daily intake, blood fat, blood sugar and blood uric acid entered the regression equation and all the regression coefficients were positive values. The OR values were 7.704,8.730,2.703,12.400 and 3.866 respectively, indicating all the factors above were risk factors. The preference to eggs and vegetables entered the regression equation and both the regression coefficients were negative values. The OR values were 0.077 and 0.075, indicating that the factors above were protective facors. (3) The contents of serum GIP on empty stomach among the 61 cases of NAFLD were obviously higher than that in the 22 cases of control group with significant difference (P<0.01). With the univariate logistic regression analysis, the results showed that the GIP was the risk factor of NAFLD, with the OR value as 3.325. With the ROC curve as the evaluation of the diagnosis significance of GIP to NAFLD, the results indicated the GIP has the diagnosis value for the NAFLD. (4) 89 cases of the first category (liver depression and spleen deficiency syndrome) of the NAFLD patients,101 cases of the third category (dampness-heat accumulation syndrome) of the NAFLD patients and 96 cases in the control group were included. With the univariate and multivariate logistic regression analysis, the results showed that BMI, edible oil daily intake, blood fat, blood sugar and blood uric acid entered the regression equation and all the regression coefficients were positive values, indicating that the factors above maybe were the risk factors to the first category (liver depression and spleen deficiency syndrome) and the third category (dampness-heat accumulation syndrome) of NAFLD. The preference to eggs and vegetables entered the regression equation and both the regression coefficients were negative values, indicating that the factors above maybe were the protective factors to the first category (liver depression and spleen deficiency syndrome) and the third category (dampness-heat accumulation syndrome) of NAFLD. (5) Based on the correlative factors of different syndromes of NAFLD, the diet and exercise schemes were pointed out.Conclusion:(1) With the Meta analysis, it was thought that TCM has better therapeutic effects on NAFLD, which has significant difference compared with that in the control group. (2) In the present study, with the Logistic regression analysis, the results showed that BMI, edible oil daily intake, abnormal blood fat, diabetes mellitus and hyperuricemia maybe were the risk factors for NAFLD and the preference to eggs and vegetables maybe were the protective factors for the NAFLD. (3) The contents of serum GIP on empty stomach among the 61 cases of NAFLD were obviously higher than that in the 22 cases of control group, indicating that GIP maybe was related with the occurrence and development of NAFLD. With the univariate logistic regression analysis, the results showed that GIP maybe was the risk factor to NAFLD. With the ROC curve as the evaluation for the diagnosis significance of NAFLD, the results showed that GIP has better diagnosis value for NAFLD.(4) The risk factors in the first category (liver depression and spleen deficiency syndrome) and the third category (dampness-heat accumulation syndrome) were BMI, edible oil daily intake, blood fat, blood sugar and blood uric acid, and the preference to eggs and vegetables were the protective factors in the first category (liver depression and spleen deficiency syndrome) and the third category (dampness-heat accumulation syndrome). (5) Based on the correlative factors of different syndromes of NAFLD, the diet and exercise schemes were pointed out.