Significance of Triglyceride-to-High- Density Lipoprotein Cholesterol Ratio in Children with Non-Alcoholic Fatty Liver Disease
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and metabolic syndrome. This study evaluated the significance of markers such as the triglyceride-to-highdensity lipoprotein cholesterol (TG/HDL-C) ratio and TG-glucose (TyG) indices in a group of patients with NAFLD. Methods: We retrospectively analyzed the data of patients aged 5–18 years diagnosed with NAFLD between January 2014 and January 2021. Results: Among the 151 patients with NAFLD, 79.5% were found to be obese, and the mean TG/HDL-C ratio (3.78±2.54 vs. 3.13±2.24) and TyG index (4.69±0.28 vs. 4.56±0.30) were slightly higher in patients with obesity compared to those without obesity. Patients with severe hepatic steatosis had a significantly higher mean TG/HDL-C ratio (4.11±2.16 vs. 3.11±2.30, p=0.035) than those with mild to moderate steatosis. Severe hepatic steatosis grade was defined as an area under the receiver operating characteristic curve of the TG/HDL-C ratio of 0.760 (95% confidence interval, 0.544–0.875), with an optimal cutoff value of 3.37. Conclusion: A high TG/HDL-C ratio is associated with severe hepatic steatosis and diabetes mellitus in children with NAFLD. Measurement of this ratio can help clinicians in identifying patients and targeting them for treatment and follow-up.
Abstract
Purpose: Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and metabolic syndrome. This study evaluated the significance of markers such as the triglyceride-to-highdensity lipoprotein cholesterol (TG/HDL-C) ratio and TG-glucose (TyG) indices in a group of patients with NAFLD. Methods: We retrospectively analyzed the data of patients aged 5–18 years diagnosed with NAFLD between January 2014 and January 2021. Results: Among the 151 patients with NAFLD, 79.5% were found to be obese, and the mean TG/HDL-C ratio (3.78±2.54 vs. 3.13±2.24) and TyG index (4.69±0.28 vs. 4.56±0.30) were slightly higher in patients with obesity compared to those without obesity. Patients with severe hepatic steatosis had a significantly higher mean TG/HDL-C ratio (4.11±2.16 vs. 3.11±2.30, p=0.035) than those with mild to moderate steatosis. Severe hepatic steatosis grade was defined as an area under the receiver operating characteristic curve of the TG/HDL-C ratio of 0.760 (95% confidence interval, 0.544–0.875), with an optimal cutoff value of 3.37. Conclusion: A high TG/HDL-C ratio is associated with severe hepatic steatosis and diabetes mellitus in children with NAFLD. Measurement of this ratio can help clinicians in identifying patients and targeting them for treatment and follow-up.
참고문헌 (24)
- Godoy-Matos AF, "NAFLD as a continuum : from obesity to metabolic syndrome and diabetes", Diabetol Metab Syndr, 12, pp.60~ (2020)
- Jung UJ, "Obesity and its metabolic complications : the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease", Int J Mol Sci, 15, pp.6184~6223 (2014)
- Gregory JW, "Prevention of obesity and metabolic syndrome in children", Front Endocrinol(Lausanne), 10, pp.669~ (2019)
- Moriyama K, "Associations between the triglyceride to high-density lipoprotein cholesterol ratio and metabolic syndrome, insulin resistance, and lifestyle habits in healthy Japanese", Metab Syndr Relat Disord, 18, pp.260~266 (2020)
- Yang Y, "Triglycerides to high-density lipoprotein cholesterol ratio is the best surrogate marker for insulin resistance in nonobese middle-aged and elderly population : a cross-sectional study", Int J Endocrinol, 2021, pp.6676569~ (2021)
- Lim J, "Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults : An analysis of the 2007-2010 Korean National Health and Nutrition Examination Survey", PLoS One, 14, pp.e0212963~ (2019)
- Lin HY, "Comparison of the triglyceride glucose index and blood leukocyte indices as predictors of metabolic syndrome in healthy Chinese population", Sci Rep, 11, pp.10036~ (2021)
- Singh SP, "NonInvasive biomarkers in nonalcoholic fatty liver disease : are we there yet?", J Clin Exp Hepatol, 10, pp.88~98 (2020)
- 김재현, "The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects", Clinical and Experimental Pediatrics, 61(5), pp.135~149 (2018), 대한소아청소년과학회
- Vos MB, "NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children : recommendations from the Expert Committee on NAFLD(ECON)and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition(NASPGHAN)", J Pediatr Gastroenterol Nutr, 64, pp.319~334 (2017)
- Association AD 2, "Classification and diagnosis of diabetes : Standards of Medical Care in Diabetes-2020", Diabetes Care, 43(Suppl 1), pp.S14~S31 (2020)
- Lim Jung Sub, "2017 Clinical practice guidelines for dyslipidemia of Korean children and adolescents", Annals of Pediatric Endocrinology & Metabolism, 25(4), pp.199~207 (2020), 대한소아내분비학회[DOI]
- Guerrero-Romero F, "The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp", J Clin Endocrinol Metab, 95, pp.3347~3351 (2010)
- Ferraioli G, "Ultrasound-based techniques for the diagnosis of liver steatosis", World J Gastroenterol, 25, pp.6053~6062 (2019)
- Chen Z, "Correlation of triglyceride to high-density lipoprotein cholesterol ratio with nonalcoholic fatty liver disease among the non-obese Chinese population with normal blood lipid levels : a retrospective cohort research", Lipids Health Dis, 18, pp.162~ (2019)
- Zhang S, "The triglyceride and glucose index(TyG)is an effective biomarker to identify nonalcoholic fatty liver disease", Lipids Health Dis, 16, pp.15~ (2017)
- Guo W, "The triglyceride-glucose index is associated with the severity of hepatic steatosis and the presence of liver fibrosis in non-alcoholic fatty liver disease : a cross-sectional study in Chinese adults", Lipids Health Dis, 19, pp.218~ (2020)
- Alcala M, "Short-term vitamin E treatment impairs reactive oxygen species signaling required for adipose tissue expansion, resulting in fatty liver and insulin resistance in obese mice", PLoS One, 12, pp.e0186579~ (2017)
- Mustapic S, "Ultrasound grade of liver steatosis is independently associated with the risk of metabolic syndrome", Can J Gastroenterol Hepatol, 2018, pp.8490242~ (2018)
- 강보경, "Correlation of Clinical and Histopathologic Parameters with Ultrasonographic Grades in Pediatric Non-Alcoholic Fatty Liver Disease", Journal of Korean Medical Science, 34(47), pp.1~10 (2019), 대한의학회
- Shou-Yu Chu, "Risk assessment of metabolic syndrome in adolescents using the triglyceride", high-density lipoprotein cholesterol ratio and the total cholesterol, Annals of Pediatric Endocrinology & Metabolism, pp.2019, 24(1)[DOI]
- Iwani NA, "Triglyceride to HDL-C ratio is associated with insulin resistance in overweight and obese children", Sci Rep, 7, pp.40055~ (2017)
- Ruiz-Jaramillo MDLC, "Triglycerides", high-density lipoprotein-cholesterol ratio in children with metabolic syndrome, 2021, pp.4, 78~88
- Rodríguez-Gutiérrez N, "Association of the triglyceride", high-density lipoprotein cholesterol index with insulin resistance in a pediatric population in Northeast Mexico, 2020, pp.18, 333~340
