The Relationship Between TG/HDL-C Ratio And Non-alcoholic Fatty Liver Disease

ObjectiveThere are two research methods in this study: 1.Cross-sectional study;2.Retrospective cohort study.The relationship between triglyceride/high-density lipoprotein cholesterol ratio(TG/HDL-C)and Nonalcoholic fatty liver disease(NAFLD)was discussed from various aspects,so as to provide theoretical basis for early detection and prevention of high-risk groups of NAFLD in clinical practice.Methods1.Cross-sectional studyAll the research objects of this subject were selected from the medical examination database of a hospital in Dalian from January 2016 to December2016.Will meet eligibility criteria in the study of the basic information of the each research object(such as gender,age,etc.),physical examination indicators(such as height,weight,waist circumference(WC),etc.),laboratory testing indicators(such as alanine amino transaminase(ALT),aspartate amino transaminase(AST),gamma glutamine transferase(GGT),etc.)and abdominal ultrasound data,detailed and accurate screening for statistical analysis.2.Retrospective cohort studyThis study also adopted another research method to provide a theoretical basis for the reliability of the conclusions of this study,that is,a retrospective cohort study.The selection of study subjects: the non-NAFLD population who met the inclusion and exclusion criteria in the cross-sectional study.Review and collect basic information,physical examination indicators,laboratory test indicators and abdominal ultrasound data for each research subject.The number of follow-up visits was greater than or equal to one,and the follow-up was terminated when the subjects developed NAFLD.Results1.Cross-sectional study1.1 After strict screening by exclusion and inclusion criteria,a total of4735 subjects(including 3024 males and 1711 females)were included in this study.As the level of TG/HDL-C increases,the proportion of men in the population,age,WC,BMI,SBP,DBP,FBG,TG,TC,LDL,ALT,AST,GGT,SUA and other indicators gradually increase,HDL-C decreased accordingly,and the trend test results showed that there was statistical significance among the indicators(P<0.05).1.2 The difference of NAFLD prevalence among the four groups was observed.The results showed that the total prevalence rate of NAFLD was36.1%,and the prevalence rate of NAFLD in Q1-Q4 group was 7.1%,22.6%,44.3% and 70.9%,respectively.the difference was statistically significant(P for trend < 0.05).1.3 Logistic regression analysis showed that there was a significant correlation between TG/HDL-C ratio and NAFLD in model 1 and model 2(adjusted for age and sex).In model 3,after adjusting BMI,WC,FGB,SUA,GGT,ALT and AST on the basis of model 2,the ratio of TG/HDL-C to NAFLD still had statistical significance,suggesting that the risk of NAFLD increased with the increase of TG/HDL-C ratio.2.Retrospective cohort study2.1 There are 2430 research subjects included in this study,of which390 have been diagnosed with NAFLD.The results of the study showed that the NAFLD group was mostly male and older.Compared with the control group,WC,BMI,SBP,DBP,FBG,SUA,ALT,AST,GGT,TG,TC,LDL-C and other indicators were all increased.The difference is statistically significant(P<0.05);while HDL-C is lower than the control group,The difference was statistically significant(P for trend < 0.05)2.2 According to TG/HDL-C level,the study subjects are divided into four groups The results showed that the cumulative incidence rates of the four groups were 3.6%,9.3%,19.2% and 32.8%,respectively.The difference was statistically significant(P for trend < 0.05)2.3 Cox regression model showed that with Q1 as the control group,when no factors were adjusted,the risk of NAFLD in Q2,Q3 and Q4 groups was2.685(1.643-4.387)times,5.562(3.525-8.778)times and 10.489(6.746-16.307)times higher than that in Q1 group,respectively.After adjusting for age and sex,the risk of NAFLD in Q2,Q3 and Q4 groups was2.328(1.421-3.814)times,4.424(2.783-7.03)times and 7.746(4.924-12.187)times higher than that in Q1 group,respectively.After adjusting BMI,WC,FGB,SUA,GGT,ALT and AST based on the above adjustment model,the risk of NAFLD in Q2,Q3 and Q4 groups was 1.938(1.182-3.178)times,3.218(2.017-5.132)times and 4.479(2.815-7.127)times higher than that in Q1 group,respectively.It is suggested that high level of TG/HDL-C increases the risk of NAFLD.2.4 ROC curve analysis showed that the area under the curve of TG/HDL-C was 0.737(0.711-0.762).When the ratio of TG/HDL-C was0.915,it was of certain significance for the diagnosis of NAFLD.Conclusion1.The higher the TG/HDL-C ratio,the greater the risk of NAFLD.2.TG/HDL-C ratio has good predictive value for NAFLD.Regular monitoring of changes in TG/HDL-C indicators in the physical examination population to assess the risk of NAFLD has important clinical significance in preventing the occurrence of NAFLD.