Background Atherogenic index of plasma (AIP) has been reported to be an important predictor for coronary artery disease and obesity. However, few studies has yet systematically evaluated the association between AIP and Fatty Liver (FL) and its advantage in FL prediction compared with BMI, waist, SBP, DBP, BG, ALT and AST. Methods A total of 7838 participants aged from 19 to 93 years were included in this study. Height, weight, waist, SBP, DBP, BG, ALT and AST were measured. Difference analyses, odds ratio calculation, logistic and predictive analyses were used to evaluate the association and discrimination ability between AIP, BMI, waist, SBP, DBP, BG, ALT, AST and FL. Results Compared with non-FL, AIP in FL people showed a significant increase. Subjects in the higher quartiles of AIP had a significantly increased risk of fatty liver compared with those in the lowest quartile (P < 0.01) after adjustment of gender and age. ORs were grown faster in female and youth group. AIP contributed most in the logistic eq. (B = 2.64, P < 0.01) and showed high ability in risk prediction for FL (AUC = 0.810, P < 0.01). Conclusions AIP might be a novel and strong predictor associated with FL in Chinese Han population. Higher AIP level was positively and strongly associated with FL.

Lower paraoxonase (PON1) activity and higher oxidized low-density lipoprotein (oxLDL) levels are main risk factors of coronary heart disease (CHD). The aim of this study is to observe the characteristics of coronary artery lesions in CHD patients with or without hyperglycemia and relationships between coronary artery lesions and oxLDL levels as well as PON1 activity. Two hundred and eighty-four participants were divided into four groups according to their coronary angiographies and fasting plasma glucose levels: CHD+diabetes mellitus (DM) (n=46); CHD+impaired fasting glucose (n=62); CHD+normal fasting glucose (NFG) (n=86); healthy control group (n=90). The CHD+DM group had more diffuse lesions, higher frequency of severe coronary stenoses or total occlusions and more multivessel lesions than those with NFG. PON1 activity in the CHD+NFG group was lower than that in control participants (P<0.05), and much lower in the CHD patients with hyperglycemia (DM and impaired fasting glucose) (P<0.01). OxLDL levels in the CHD+DM group were higher than in the CHD+NFG group (P<0.05). In the CHD patients with hyperglycemia, the patients of multivessel lesions had higher oxLDL levels than those of single-vessel lesions (P<0.05) and the patients of severe stenosed vessels had obviously lower PON1 activity than those of mild and moderate stenosed vessels (P<0.01), whereas oxLDL levels were higher in the patients with diffuse lesions than those with focal lesions(P<0.05). In the multivariate analysis, the patients in the highest quartile of oxLDL level had an increased likelihood of having multivessel lesions or diffuse lesions compared with those in the lowest quartile [odds ratio (OR)=49.46, P=0.001; OR=34.30, P<0.001, respectively] whereas there was a negative correlation between two upper quartiles of serum PON1 activity and the likelihood of severe stenoses or total occlusions among the CHD patients with hyperglycemia (the top quartile, OR=0.14, P=0.008; the third quartile, OR=0.22, P=0.033). Lower PON1 activity and higher oxLDL levels may be predicting factors that denote diffuse, severe or multivessel disease in CHD patients with hyperglycemia.

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BACKGROUNDThe Baveno VI criteria for predicting esophageal varices, i.e., liver stiffness measurement (LSM) < 20 kPa and platelet (PLT) count > 150 × 109/L, identify patients who can safely avoid gastroscopy screening. However, they require further refinement.AIMTo evaluate the utility of LSM and serum markers of liver fibrosis in ruling out high-risk varices (HRV) in patients who do not meet Baveno VI criteria.METHODSData from 132 patients with hepatitis B virus (HBV)-related compensated liver cirrhosis who did not meet the Baveno VI criteria were retrospectively reviewed. MedCalc 15.8 was used to calculate receiver operating characteristic (ROC) curves, and the accuracy of LSM, PLT count, aspartate aminotransferase (AST)-to-PLT ratio index, Fibrosis-4, and the Lok index in predicting HRV were evaluated according to the area under each ROC curve (AUROC). The utility of LSM, PLT, and serum markers of liver fibrosis stratified by alanine transaminase (ALT) and total bilirubin (TBil) levels was evaluated for ruling out HRV.RESULTSIn all patients who did not meet the Baveno VI criteria, the independent risk factors for HRV were LSM and ALT. Only the AUROC of Lok index was above 0.7 for predicting HRV, and at a cutoff value of 0.4531 it could further spare 24.2% of gastroscopies without missing HRVs. The prevalence of HRV was significantly lower in patients with ALT or TBil ≥ 2 upper limit of normal (ULN) (14.3%) than in patients with both ALT and TBil < 2 ULN (34.1%) (P = 0.018). In the 41 patients with ALT and TBil < 2 ULN, LSM had an AUROC for predicting HRV of 0.821. LSM < 20.6 kPa spared 39.0% of gastroscopies without missing HRVs. In the 91 patients with ALT or TBiL ≥ 2 ULN, the Lok index and PLT had AUROCs of 0.814 and 0.741, respectively. Lok index ≤ 0.5596 or PLT > 100 × 109/L further spared 39.6% and 43.9% of gastroscopies, respectively, without missing HRVs.CONCLUSIONIn HBV-related compensated cirrhosis patients who do not meet Baveno VI criteria, the LSM, PLT, or Lok index cutoff stratified by ALT and TBil accurately identifies more patients without HRV.

SRS combined with PCDV is superior to PCDV with splenectomy and selective PCDV for PHT in liver cirrhotic patients in inhibiting the occurrence and development of postoperative PVT and improving liver function.