2026 年第 5 期 第 21 卷

血浆致动脉粥样硬化指数预测瘦型代谢相关脂肪性肝病的临床价值

Clinical value of atherogenic index of plasma in predicting lean metabolic-associated fatty liver disease

作者：杨琴曹春莉

英文作者：Yang Qin Cao Chunli

单位：内蒙古医科大学附属医院消化内科，呼和浩特010010

英文单位：Department of Gastroenterology the Affiliated Hospital of Inner Mongolia Medical University Hohhot 010010 China

关键词：血浆致动脉粥样硬化指数；瘦型；代谢相关脂肪性肝病；预测价值

英文关键词：Atherogenicindexofplasma;Leanphenotype;Metabolic-associatedfattyliverdisease;Predictivevalue

• 摘要：

• 目的 探讨血浆致动脉粥样硬化指数（AIP）预测瘦型代谢相关脂肪性肝病（MAFLD）的临床价值。方法 选择2024年1月至2025年1月在内蒙古医科大学附属医院进行健康检查的体检人员。比较瘦型MAFLD（观察组）和瘦型健康体检者（对照组）一般资料和检查资料，多因素Logistic回归分析体重指数＜23 kg/m2人群发生瘦型MAFLD的相关因素，绘制受试者工作特征曲线分析各指标预测瘦型MAFLD的临床价值；比较高AIP组、低AIP组瘦型MAFLD发生率。结果 本研究共筛选出瘦型MAFLD患者56例（观察组），瘦型健康体检者214例（对照组）。观察组年龄、性别、体重指数、收缩压、舒张压、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶、γ-谷氨酰转移酶、碱性磷酸酶、肾功能、血脂、空腹血糖及AIP与对照组比较差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析结果 显示，年龄、性别、体重指数、ALT、AIP是体重指数＜23 kg/m2人群发生MAFLD的独立影响因素（均P＜0.05）。体重指数、ALT、AIP联合预测瘦型MAFLD的曲线下面积（AUC）为0.904，AUC值高于各指标单独预测（Z=3.476、3.625、3.029，P=0.018、0.013、0.020）。高AIP组瘦型MAFLD发生率高于低AIP组［43.3%（42/97）比8.1%（14/173）］（χ2=46.863，P＜0.001）。结论 AIP是体重指数＜23 kg/m2人群MAFLD发生的独立危险因素，AIP联合体重指数、ALT预测体重指数＜23 kg/m2人群MAFLD具有较高的临床价值。

• Objective To investigate the clinical value of atherogenic index of plasma (AIP) in predicting lean metabolic-associated fatty liver disease (MAFLD). Methods Physical examinees who underwent health examination at The Affiliated Hospital of Inner Mongolia Medical University from January 2024 to January 2025 were enrolled. General and laboratory data were compared between patients with lean MAFLD (observation group) and lean healthy examinees (control group). Multivariate Logistic regression analysis was used to analyze factors associated with lean MAFLD in individuals with body mass index (BMI)<23 kg/m2. Receiver operating characteristic curve was drawn to analyze the clinical value of each index in predicting lean MAFLD. The incidence of lean MAFLD was compared between high AIP group and low AIP group. Results A total of 56 patients with lean MAFLD (observation group) and 214 lean healthy examinees (control group) were screened. There were significant differences in age, gender, BMI, systolic blood pressure, diastolic blood pressure, alanine aminotransferase (ALT), aspartate aminotransferase, γ-glutamyl transferase, alkaline phosphatase, renal function, blood lipid, fasting blood glucose and AIP between the observation group and the control group (all P<0.05). Multivariate Logistic regression analysis showed that age, gender, BMI, ALT and AIP were independent influencing factors for MAFLD in individuals with BMI<23 kg/m2 (all P<0.05). The area under the curve (AUC) of combined prediction of lean MAFLD by BMI, ALT and AIP was 0.904, which was higher than that of single index prediction (Z=3.476, 3.625, 3.029; P=0.018, 0.013, 0.020). The incidence of lean MAFLD in high AIP group was higher than that in low AIP group ［43.3%(42/97) vs 8.1%(14/173)］(χ2=46.863, P<0.001). Conclusion AIP is an independent risk factor for MAFLD in individuals with BMI<23 kg/m2. Combination of AIP, BMI and ALT has high clinical value in predicting MAFLD in individuals with BMI<23 kg/m2.