Correlation Between NAFLD Liver Fibrosis Progression And Metabolic Factors Based On FibroTouch

Objective: The liver stiffness measurement(LSM)of patients with nonalcoholic fatty liver disease(NAFLD)was determined based on FibroTouch(FT),and the correlation between the liver fibrosis progression in NAFLD and metabolic factors was analyzed around the metabolic indexes such as body mass index(BMI),blood lipid,fasting blood glucose and renal function.We explored whether the progression of liver fibrosis in NAFLD would have an impact on the metabolic system,so as to provide early warning for the metabolic system diseases secondary to the progression of liver fibrosis in NAFLD.Methods: A total of 327 NAFLD patients diagnosed by B-ultrasound from April 2019 to October 2020 were retrospectively collected in the Department of Hepatology,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine.The patients’ name,gender,age,height,weight,TCM syndrome(symptoms,signs,tongue and pulse),BMI,liver function,renal function,blood lipid,fasting blood glucose and other data were collected and recorded.At the same time,the LSM value and FAP value(fat attenuation parameter)were detected by FibroTouch,and the correlation between LSM value and age,gender,BMI,blood lipid,fasting blood glucose,renal function and other indicators was analyzed.327 subjects were included in the study,and the correlation between metabolic factors and LSM value was analyzed by bivariate correlation statistics;logistic binary regression was used to analyze the influencing factors of LSM value in no liver fibrosis group and liver fibrosis group,mild liver fibrosis group and significant liver fibrosis group;The distribution of 5 common TCM syndromes of NAFLD was analyzed;the correlation between TCM Syndrome and LSM value,FAP value was analyzed by one-way ANOVA;the distribution of common TCM symptoms of metabolic diseases in NAFLD patients was analyzed.Results: 1.According to LSM values,the subjects were divided into three groups: no liver fibrosis group,mild liver fibrosis group and significant liver fibrosis group.It was found that CHOL,TG,HDL,GLU and BMI were significantly different Between these three groups(P<0.05).BMI,CHOL,GLU were positively correlated with LSM(r>0).HDL,TG were negatively correlated with LSM(r<0).2.According to LSM value,the subjects were divided into no liver fibrosis group and liver fibrosis group,slight liver fibrosis group and significant liver fibrosis group;there were significantly different in BMI,GLU between no liver fibrosis group and liver fibrosis group(P<0.05),the coefficients were 1.136 and 1.531;there were significantly different in BMI,GLU between slight liver fibrosis group and significant liver fibrosis group,TG,BMI,GLU and LSM values were significantly different(P<0.05),the coefficients were 1.257,2.23 and 1.189.BMI and GLU were correlated with LSM.3.The distribution of TCM syndrome types of 327 subjects were liver stagnation and spleen deficiency syndrome(36.09%),phlegm dampness trapping spleen syndrome(29.05%),damp heat obstructing syndrome(17.43%),qi stagnation and blood stasis syndrome(11.62%),spleen kidney yang deficiency syndrome(5.81%).The patients with liver depression and spleen deficiency syndrome were the main ones in no liver fibrosis group,mild liver fibrosis group and significant liver fibrosis group.4.According to the different TCM syndrome types of NAFLD,they were divided into five groups,namely liver depression and spleen deficiency syndrome group,phlegm dampness trapped spleen syndrome group,damp heat syndrome group,qi stagnation and blood stasis syndrome group,spleen and kidney yang deficiency syndrome group.The LSM value of the five groups of patients with different syndrome types had significant difference(P<0.001),and the LSM value of the patients with spleen and kidney yang deficiency syndrome was the highest;the FAP value of the five groups of patients with different syndrome types had no significant difference(P>0.05).5.Based on the frequency statistics of 327 cases of TCM symptoms,the common TCM clinical symptoms of metabolic system diseases were selected,and the symptoms with frequency >10% were statistically analyzed.The most common TCM symptoms were fatigue,epigastric fullness,indigestion,nausea and vomiting,etc.Conclusion: 1.BMI and GLU are closely related to LSM value of NAFLD,and the progression of NAFLD liver fibrosis has certain influence on BMI and GLU;Controlling the progress of liver fibrosis in NAFLD patients has positive significance for improving obesity and abnormal carbohydrate metabolism.2.There are differences in LSM values among different TCM syndromes of NAFLD,the LSM value of NAFLD patients with spleen kidney yang deficiency syndrome was the highest.The LSM value can provide reference for TCM syndrome differentiation of NAFLD.3.The most common TCM syndrome type of NAFLD is liver depression and spleen deficiency,followed by phlegm dampness trapping spleen syndrome,damp heat obstructing syndrome,qi stagnation and blood stasis syndrome,spleen and kidney yang deficiency syndrome;the most common clinical symptoms related to metabolism of NAFLD patients are mental fatigue,epigastric distension,abdominal fullness,lack of appetite,nausea and vomiting,etc.