ABSTRACT
Objective:To investigate the association of surrogate indexes of insulin resistance with the risk of nonalcoholic fatty liver disease(NAFLD)and advanced liver fibrosis in newly diagnosed patients with type 2 mellitus.Methods:A total of 429 newly diagnosed type 2 diabetic patients hospitalized in the Department of Endocrinology and Metabolism, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from June 2018 to June 2020 were included. The patients were divided into NAFLD group( n=263)and non-NAFLD group( n=166)according to the results of abdominal ultrasound, NAFLD patients were divided into advanced liver fibrosis group( n=33)and non-advanced liver fibrosis group( n=230)according to the NAFLD fibrosis score(NFS). The correlation of the triglyceride/high density lipoprotein-cholesterol ratio(TG/HDL-C), triglyceride glucose index(TyG), visceral adiposity index(VAI), triglyceride glucose-body mass index(TyG-BMI), homeostasis model assessment of insulin resistance index(HOMA-IR)with NAFLD and the occurrence of advanced liver fibrosis were analyzed. Results:The prevalence of NAFLD in newly diagnosed type 2 diabetic patients was 61.3%, and the prevalence of advanced liver fibrosis was 12.5%. After adjusting the potential confounders, multivariate logistic regression analysis showed that TG/HDL-C, TyG, VAI, TyG-BMI, and HOMA-IR were independently and positively correlated with NAFLD, and only TyG-BMI was independently and positively correlated with advanced liver fibrosis( OR=1.021, 95% CI 1.009-1.034, P<0.01). The receiver operating characteristic analysis showed that the area under the curue of TyG-BMI was more than those of TG/HDL-C, TyG, VAI and HOMA-IR for predicting the occurrence of NAFLD in newly diagnosed type 2 diabetic patients(0.83 vs 0.73, 0.74, 0.73, 0.67, P<0.01), but had no predictive value for advanced liver fibrosis. Conclusion:TyG-BMI is superior to TG/HDL-C, TyG, VAI and HOMA-IR for predicting the occurrence of NAFLD in newly diagnosed type 2 diabetic patients, and it is also an independent risk factor for advanced liver fibrosis.
ABSTRACT
Objective To investigate the correlations between peripheral absolute lymphocyte count (ALC) and clinicopathological characteristics of newly diagnosed elderly patients with multiple myeloma (MM)and its prognosis.Methods A total of 57 elderly patients with MM were selected in Wuxi People's Hospital Affiliated to Nanjing Medical University from January 1,2007 to December 31,2015.The patients were grouped as ALC ≥ 1.3 × 109/L (n =24) and ALC ＜ 1.3 × 109/L (n =33).The ALC and clinical characteristics of the patients were collected.The chi-square test,rank sum test,Cox regression analysis,Kaplan-Meier analysis and Log-rank test were used to analyze the correlation of ALC with clinicopathological characteristics,curative effect and prognosis of elderly patients with MM.Results The peripheral ALC of elderly MM patients was related to hemoglobin content (x2 =6.915,P =0.009),but it was not related to the sex,age,DurieSalmon stage,international staging system stage,creatinine content,lactate dehydrogenase content,albumin content,concentration of Ca2 +,performance status and classification (all P ＞ 0.05).There was no significant difference in efficacy between ALC ≥ 1.3 × 109/L group and ALC ＜ 1.3 × 109/L group (Z =0.464,P =0.642).In univariate analysis,age (RR =2.843,95 ％ CI:1.385-5.835,P =0.004),sex (RR =2.092,95％ CI:1.034-4.231,P =0.040),ALC (RR =3.562,95％ CI:1.539-8.244,P =0.003),hemoglobin content (RR =3.583,95％ CI:1.087-11.811,P =0.036),lactate dehydrogenase content (RR =3.192,95％ CI:1.580-6.452,P =0.001) and curative effect (RR =5.202,95％ CI:1.184-22.864,P =0.029)were related to the prognosis of patients.Multivariate analysis results revealed that age (RR =2.672,95％ CI:1.235-5.782,P =0.013) and ALC (RR =2.613,95 ％ CI:1.092-6.250,P =0.031) were independent predictive factors for patients with MM.Kaplan-Meier analysis indicated that the median overall survival of ALC ≥1.3 × 109/L group was significantly longer than that of ALC ＜ 1.3 × 109/L group (69 months vs.24 months;x2 =10.171,P =0.001).Conclusion The peripheral ALC in elderly patients with MM is related to hemoglobin content.ALC is an independent prognostic factor for the elderly patients with newly diagnosed MM,and has clinical value for the prognosis of MM.