探讨超声脂肪分数（UDFF）对中青年代谢相关脂肪性肝病（MAFLD）患者病情严重程度及糖脂代谢的评估价值。

回顾性分析2022年3月至2025年3月内江市第二人民医院收治的152例中青年MAFLD患者的临床资料，所有患者均检测UDFF、磁共振质子密度脂肪分数（MRI-PDFF），根据患者病情严重程度分为轻度脂肪性肝病组（PDFF S1）102例，中重度脂肪性肝病组（PDFF S2、S3）50例；收集患者的糖脂代谢相关指标[空腹血糖（FBG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）]。根据MAFLD患者的不同糖脂代谢程度，以是否出现明显肝纤维化进行分组，出现明显肝纤维化患者为A组，无/轻微肝纤维化患者为B组，比较不同组别间的UDFF差异。绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC）评估UDFF对MAFLD患者病情严重程度及糖脂代谢的诊断价值。

轻度组FBG、HOMA-IR、TC、TG、LDL-C高于中重度组，HbA1c、HDL-C、UDFF低于中重度组，差异均有统计学意义（P<0.05）；A组UDFF值（7.66±1.20）%低于B组的（12.23±3.49）%，差异有统计学意义（t=11.400，P<0.001）。Logistic回归分析显示，UDFF与MAFLD病情严重程度具有正相关性（OR=7.503，95% CI 3.427~16.456，P<0.001）；ROC曲线显示，UDFF评估MAFLD患者病情严重程度的AUC为0.856（95% CI 0.825~0.886），最佳截断值18.5%，灵敏度86%，特异度82%。Logistic回归分析显示，UDFF与糖脂代谢异常显著正相关（P<0.001），UDFF每增加1%，MAFLD患者糖脂代谢异常风险升高132%（OR=2.325，95% CI 1.852~2.912，P<0.001）；ROC曲线显示，UDFF评估MAFLD患者糖脂代谢程度的AUC为0.873，最佳截断值为9.5%，灵敏度80.3%，特异度76.5%。

UDFF通过定量肝脏脂肪含量，对不同病情严重程度的MAFLD患者诊断效能较好，有助于评估反映糖脂代谢异常和肝纤维化程度，为临床诊断和治疗提供参考。

To investigate the value of ultrasound fat fraction (UDFF) in evaluating the severity of disease and glucose lipid metabolism in young and middle-aged patients with metabolism-related fatty liver disease (MAFLD).

A retrospective analysis was carried out on the clinical data of 152 young and middle-aged MAFLD patients admitted to the Second People's Hospital of Neijiang City from March 2022 to March 2025. All patients were examined for UDFF and magnetic resonance proton density fat fraction (MRI-PDFF). According to the pathological grade of liver steatosis, all patients were divided into two groups: 102 cases in the mild fatty liver disease group (PDFF S1) and 50 cases in the moderate-to-severe fatty liver disease group (PDFF S2、S3); the relevant indicators related to glycolipid metabolism [fasting blood glucose (FBG), glycated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)] of the patients were collected; and the patients with MAFLD were grouped based on the different degrees of glycolipid metabolism, they were also grouped based on whether there was obvious liver fibrosis, among them, patients with obvious liver fibrosis were classified as group A and patients without/with minor liver fibrosis were classified as group B, and the UDFF differences between different groups were compared. The receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to evaluate the diagnostic value of UDFF for the disease classification and glycolipid metabolism of MAFLD patients.

The levels of FBG, HOMA-IR, TC, TG and LDL-c in the mild group were higher than those in the moderate to severe group, while HbA1c, HDL-c and UDFF were lower than those in the moderate to severe group, with statistically significant differences (P<0.05). The UDFF in group A was (7.66±1.20)%, which was lower than that in group B [(12.23±3.49)%], with a statistically significant difference (t=11.400, P<0.001). The results of Logistic regression analysis showed that UDFF was positively correlated with the severity of MAFLD (OR=7.503, 95% CI: 3.427-16.456, P<0.001), the ROC curve showed that the AUC of UDFF in evaluating the severity of the disease in patients with MAFLD was 0.856 (95% CI: 0.825-0.886), the optimal cut-off value was 18.5%, the sensitivity was 86%, and the specificity was 82%. The results of Logistic regression analysis showed that UDFF was significantly positively correlated with abnormal glycolipid metabolism (P<0.001), for every 1% increase in UDFF, the risk of abnormal glycolipid metabolism in patients with MAFLD increased by 132% (OR=2.325, 95% CI: 1.852-2.912, P<0.001), the ROC curve showed that the AUC of UDFF in evaluating the degree of glycolipid metabolism in patients with MAFLD was 0.873, the optimal cut-off value was 9.5%, the sensitivity was 80.3%, and the specificity was 76.5%.

By quantifying liver fat content, UDFF has a good diagnostic efficacy for MAFLD patients with different severity of disease, which helps to evaluate the degree of abnormal glucose and lipid metabolism and liver fibrosis, and provides an important reference for clinical diagnosis and treatment.