空腹胰岛素在体重指数与非酒精性脂肪性肝病之间的中介效应

黄彩虹; 韦玉霜; 韦春梦; 黄芳梅; 黎也新; 麦小游; 苏卉伟; 梁莉敏; 刘福强; 刘春奇; 廖金玲; 莫曾南; 李龙嫚

doi:10.16190/j.cnki.45-1211/r.2023.03.024

空腹胰岛素在体重指数与非酒精性脂肪性肝病之间的中介效应

Mediating effect of fasting insulin on the association between body mass index and nonalcoholic fatty liver disease

摘要

摘要: 目的：探讨空腹胰岛素（FINS）在体重指数与非酒精性脂肪性肝病（NAFLD）关联中的中介效应。方法：本研究共纳入389名NAFLD 患者和1 530名健康体检者。采用多因素logistic回归分析评估体重指数和FINS与NAFLD之间的关系；采用多因素线性回归分析探讨体重指数与FINS 之间的关系；采用Bootstrap 法分析FINS 在体重指数与NAFLD 关联中的中介效应。结果：在调整相关混杂因素后，体重指数、FINS 与NAFLD 患病风险的关联具有统计学意义（OR=1.434，95%CI：1.352～1.521，P＜0.001；OR_FINS=1.048，95%CI：1.026～1.071，P＜0.001）；体重指数增加与FINS 水平升高的关联具有统计学意义（B=0.723，95%CI：0.618～0.828，P＜0.001）；FINS在体重指数与NAFLD 关联中具有中介效应（效应值0.034，95%CI：0.015～0.059），中介效应占比为8.61%。结论：FINS在体重指数与NAFLD的关联中发挥部分中介效应。

Abstract: Objective: To explore the mediating effect of fasting insulin (FINS) on the association between body mass index and nonalcoholic fatty liver disease (NAFLD).Methods: A total of 389 NAFLD patients and 1, 530 healthy subjects were enrolled in this study.Multivariate logistic regression analysis was applied to evaluate the associations of body mass index and FINS with NAFLD.Multivariate linear regression analysis was applied to estimate the association between body mass index and FINS.The Bootstrap method was used to analyze the mediating effect of FINS on the association between body mass index and NAFLD.Results: After adjusting for relevant confounding factors, the associations of body mass index and FINS with the risk of NAFLD were statistically significant (OR=1.434, 95% CI:1.352-1.521, P＜0.001; OR_FINS=1.048, 95%CI:1.026-1.071, P＜0.001, respectively).The association between increased body mass index and increased FINS level was statistically significant(B=0.723, 95%CI:0.618-0.828, P＜0.001).FINS had a mediating effect(effect value 0.034, 95% CI: 0.015-0.059) on the association between body mass index and NAFLD, and the mediating effect accounted for 8.61%.Conclusion: FINS plays a partial mediating role on the association between body mass index and NAFLD.

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