目的 探讨老年人腰臂比(WAR)与代谢功能障碍相关脂肪性肝病(MASLD)及肝纤维化之间相关性。方法 选取2017-2020 年美国国家健康与营养调查(NHANES)数据库中60岁以上的老年人,以WAR为暴露变量,按四分位数分组,评估其与MASLD及肝纤维化的关联。采用多变量 logistic 回归模型分析WAR与MASLD及肝纤维化发生风险之间的关系,同时进行亚组分析、交互作用检验,并采用限制性三次样条分析评估非线性关联。结果 研究共纳入2084名参与者,MASLD患病率为42.7%,肝纤维化的患病率为14.3%。WAR按四分位数分组,每组均包含521名参与者。多变量 logistic 回归分析结果显示,WAR升高与MASLD发生风险呈显著正相关(完全调整模型OR=2.51, 95%CI:1.69~3.72,P<0.001),Q4组较Q1组MASLD发生风险增加1.12倍(OR=2.12,95%CI:1.56~2.88,P<0.001)。同样的,WAR升高与肝纤维化发生风险亦呈显著正相关(完全调整模型OR=2.35, 95%CI:1.45~3.83,P=0.001),Q4组较Q1组肝纤维化发生风险增加1.11倍(OR=2.11,95%CI:1.37~3.24,P=0.001)。亚组分析显示该关联在各亚组中保持一致。限制性立方样条(RCS)提示WAR与MASLD及肝纤维化均呈线性关联(非线性检验P＞0.05)。结论 老年人WAR与MASLD及肝纤维化风险呈显著正相关。
Abstract
Objective To explore the potential association between the waist-to-arm ratio(WAR) and both metabolic dysfunction-associated steatotic liver disease (MASLD) and hepatic fibrosis in older adults. Methods A total of 60-year-old and above elderly individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020 were selected. WAR was used as the exposure variable and was categorized according to quartiles to assess its association with MASLD and hepatic fibrosis. Multivariable logistic regression model was used to estimate the relationship between WAR and the risk of MASLD and hepatic fibrosis, and subgroup analyses, interaction tests and restricted cubic spline analysis were performed to assess the non-linear association. Results A total of 2,084 participants were included in the study. The prevalence of MASLD was 42.7%, and that of hepatic fibrosis was 14.3%. WAR was divided into quartiles (Q1-Q4), each comprising 521 individuals. Multivariable logistic regression revealed a significant, positive association between higher WAR and the risk of MASLD (fully adjusted model OR=2.51; 95% CI, 1.69-3.72; P<0.001) , and the risk of MASLD in the Q4 group was 1.12 times higher than that in the Q1 group (OR=2.12; 95% CI, 1.56-2.88; P<0.001). Similarly, an increase in WAR was also significantly positively associated with the risk of hepatic fibrosis (fully adjusted model OR=2.35; 95% CI, 1.45-3.83; P=0.001), and the risk of hepatic fibrosis in the Q4 group was 1.11 times higher than that in the Q1 group (OR=2.11; 95% CI, 1.37-3.24; P=0.001). Subgroup analyses confirmed the consistency of these associations across all subgroups. Restricted cubic spline(RCS) regression indicated linear relationship between WAR and both MASLD and hepatic fibrosis (non-linearity P>0.05). Conclusions In older adults, WAR is significantly positively associated with the risk of MASLD and hepatic fibrosis.
关键词
代谢功能障碍相关脂肪性肝病 /
肝纤维化 /
腰臂比值 /
健康与营养调查
Key words
metabolic dysfunction-associated steatotic liver disease /
waist-to-arm ratio /
hepatic fibrosis /
health and nutrition survey
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