目的 了解预后营养指数(PNI)与男性脂肪肝患者胰岛素抵抗( IR)之间的相关性,为脂肪肝患者的临床管理提供 科学依据。 方法 采用横断面调查方法分析 2019 年 1 月至 2021 年 12 月在西南医科大学附属医院健康管理中心进行体检的男 性体检者资料,并根据腹部超声结果诊断脂肪肝。 根据甘油三酯-葡萄糖指数(TyG)定义 IR,并将 PNI 评分按照三分位数进 行分组(Q1 组为 PNI<55. 36;Q2 组为 55. 36≤PNI<58. 56;Q3 组为 PNI≥58. 56),以 Q1 组作为参考,通过单因素、多因素 Logistic 回归分析 PNI 与 IR 的关系。 结果 本研究共纳入 714 例男性脂肪肝患者,其中 490 例存在 IR(68. 63%)。 单因素 Logistic 回 归分析显示,PNI 是男性脂肪肝患者 IR 的危险因素。 PNI 在 55. 36≤PNI< 58. 56 及 PNI≥58. 56 水平时,IR 的风险分别是 PNI<55. 36 组的 1. 717 倍及 2. 264 倍;多因素 Logistic 回归分析结果显示,PNI 是男性脂肪肝患者 IR 的危险因素,校正体质指 数(BMI)、腰围(WC)、内脏脂肪面积(VFA)、总胆固醇(TC)等混杂因素后,与 PNI<55. 36 组相比,PNI 水平在 55. 36≤PNI< 58. 56 和 PNI≥58. 56 的患者 IR 风险分别增加了 1. 694 倍和 1. 710 倍。 结论 PNI 可作为评估男性脂肪肝患者 IR 状况的指 标,甚至可能成为 IR 发生的预测因子。

Objective To investigate the correlation between prognostic nutritional index PNI and insulin resistance IR in male patients with fatty liver disease and to provide a scientific basis for the clinical management of patients with fatty liver disease. Method A cross-sectional survey Method was used to analyze the data from male individuals who underwent health examinations at the Health Management Center of the Affiliated Hospital of Southwest Medical University between January 2019 to December 2021 and fatty liver was diagnosed based on abdominal ultrasound results. IR was defined according to the triglyceride-glucose index TyG and PNI scores were categorized into tertiles Q1 PNI < 55. 36 Q2 55. 36 ≤ PNI < 58. 56 Q3 PNI ≥58. 56 . Logistic regression analysis was employed to examine the association between PNI and IR with the Q1 group serving as the reference. Result A total of 714 male patients with fatty liver were included in this study of which 490 had IR 68. 63% . The results of univariate and multivariate logistic regression analysis showed that PNI is a risk factor for IR in male patients with fatty liver disease. Univariate logistic regression analysis compared with the PNI < 55. 36 group the risk of IR when PNI levels were 55. 36 ≤ PNI < 58. 56 and PNI ≥ 58. 56 increased by 1. 717 times and 2. 264 times greater respectively. Multivariate logistic regression analysis after adjusting for confounding factors such as body mass index waist circumference visceral fat area and total cholesterol compared with the PNI < 55. 36 group the risk of IR when PNI levels were 55. 36≤ PNI < 58. 56 and PNI≥58. 56 increased by 1. 694 and 1. 710 times respectively. Conclusion PNI may serve as a useful indicator for assessing the risk of IR in male patients with fatty liver and may potentially be a predictor of IR onset.