TyG, PLR 与代谢相关脂肪性肝病合并慢性乙型肝炎患者肝纤维化的 关系研究.

Objective: To investigate the relationship between triglyceride glucose index (TyG), platelet-to-lymphocyte ratio(PLR) and liver fibrosis in patients with metabolic associated fatty liver disease (MAFLD) complicated with chronic hepatitis B (CHB), in order to provide help for clinical diagnosis and treatment. Methods: 100 patients with MAFLD combined with CHB were selected from The Second Hospital of Lanzhou University from January 2021 to August 2023. The patients were divided into the excluded liver fibrosis group (n=44), the uncertain liver fibrosis group(n=38) and the liver fibrosis group(n=18) according to the liver fibrosis 4 factor index(FIB-4). Baseline data and laboratory test indicators were compared among the three groups. Spearman was used to analyze the correlation between FIB-4 index and clinical indicators. Multivariate logistic regression was used to analyze the influencing factors of liver fibrosis. Receiver operating characteristic curve(ROC) was used to analyze the efficacy of TyG and PLR in evaluating liver fibrosis. Results: The patients in the liver fibrosis group were the oldest, the levels of ALT, AST, GGT, DBIL and TyG were the highest, and the levels of diastolic blood pressure,lymphocyte count, PLT, LDL-C, UA, PLR, TC/HDL-C and LDL/HDL-C were the lowest. FIB-4 index was positively correlated with age, DBIL, TG/HDL-C and TyG(all P<0.01), and negatively correlated with ALB, TC/HDL-C, LDL/HDL-C and PLR(all P<0.01). Age, DBIL, TyG and LDL / HDL-C were independent risk factors for liver fibrosis in MAFLD patients with CHB(all P<0.05). ROC curve analysis showed that the area under the curve(AUC) of TyG in predicting liver fibrosis was 0.674, the sensitivity was 88.9 %, and the specificity was 56.1 %. The AUC of PLR in predicting liver fibrosis was 0.718, the sensitivity was 77.8 %, and the specificity was 65.9 %. Conclusion: TyG and PLR are related to the severity of liver fibrosis in MAFLD patients with CHB. Both of them have high predictive value for the occurrence of liver fibrosis in MAFLD patients with CHB, and can be used to identify the risk of liver fibrosis in MAFLD patients with CHB early. [ABSTRACT FROM AUTHOR]