Prediction of Fatty Liver from Serum triglyceride Levels and Body Weight Indexes

以血清三酸甘油脂又體重指標來預測脂肪肝

劉姿吟(Tzu-Yin Liu) ； 盧勝男(Sheng-Nan Lu) ； 蘇旺彬(Wang-Pin Su) ； 張文宇(Wen-Yu Chang) ； 王良彥(Liang-Yen Wang) ； 謝明裕(Ming-Yuh Hsieh) ； 莊萬龍(Wan-Long Chuang) ； 陳信成(Shinn-Cherng Chen) ； 陳建仁(Chien-Jen Chen)

《The Kaohsiung Journal of Medical Sciences》 6卷6期 (1990/06) Pp. 289-294

https://doi.org/10.6452/KJMS.199006.0289

摘要

脂肪肝是台灣常見的疾病。本研究嘗試以臨床資料來預測脂肪肝的存在以取代肝切片及超音波掃瞄診斷之效度評估。從布袋地區成人健康普查中，針對873名接受血清三酸甘脂檢查、身高體重測量、葡萄糖耐受試驗及上腹部超音波掃瞄資料完整者進行分析。以年齡、性別及糖尿病有無將民眾分為八組，用receiver operating characteristic曲線來找出各組以血清三酸甘油脂及體重指標來預測脂肪肝的臨界值並計算其敏感性、特異性及正確性。各組以血清三酸甘油魯來預測脂肪肝之臨界值變化較大，效度也較差，其臨界值大部份為130或140 mg/dl。各組以體重指標來預測脂肪肝的臨界值為115%或120%，效度比三酸甘油脂為佳，預測之正確性與各組脂肪肝盛行率成正相關。然而非糖尿病女性之體重指標對脂肪肝預測較差，其正確性小於70%。我們的結論為體重指標是預測脂肪肝之良好參數，特別是對高盛行率組較好。同時我們建議三酸甘油脂及體重指標之健康臨界值分別為130 mg/dl及115%。

並列摘要

Fatty liver is a common disease in Taiwan. In this study, we tried to evaluate the validity of predicting the presence of fatty liver from clinical data instead of liver biopsy or sonography. From a community survey in Putai, a total of 873 adults older than 30 years and quantified as to triglyceride level, body height, body weight, and the results of the oral glucose tolerance test and upper abdominal sonography were recruited for analysis. Using a receiver operating characteristic (ROC) curve, the est ‘cutoff values’ for determination of fatty liver were predicted from body weight index and serum trigyceride level in 8 clusters grouped by sex, age and presence or absence of diabetes mellitus. The best cutoff values of triglyceride in the 8 clusters varied from 100 to 170 mg/dl with worse validity. Most of the values were 130 and 140 mg/dl. The cutoff values of body weight index were constant in all clusters and showed greater validity than those for triglyceride. They were 115% or 120%. Their accuracy for the prediction of fatty liver was positively correlated wit hits prevalence. However, their accuracy was lower than 70% in non-diabetic females. We conclude that body weight index is a good parameter for prediction of fatty liver especially in the high risk groups and we recommend that health-determining cutoff values of serum triglyceride and body weight index should be set at 130 mg/dl and 115%, respectively.

並列關鍵字

fatty liver ； body weight index (BWI) ； triglyceride (TG)