上海市社区60岁以上人群脂肪肝患病率及危险因素的横断面研究

Cross-sectional study on prevalence of fatty liver and its risk factors in community elderly of Shanghai

目的了解上海市社区60岁以上人群脂肪肝的患病率及危险因素。方法对闵行区梅陇社区7534名60岁以上人群定期体检,填写统一设计的调查表,内容包括:一般情况、实验室检查、B型超声检查结果等。结果其中女性4198名,男性3336名,女男之比为1.26:1,平均年龄(68.8±7.0)岁。经B型超声检出脂肪肝3074例,占40.80%。60岁以上老年人脂肪肝患病率随着年龄增加而呈下降趋势,患病率最高的年龄段为60～64岁,达到45.20%。80岁以下,女性患病率显著高于男性。脂肪肝组的体质指数(BMI)、腰围、腰臀比(WHR)、三酰甘油、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、ALT、γ-谷氨酸转肽酶(GGT)等指标显著高于非脂肪肝组,而高密度脂蛋白胆固醇(HDL-C)则低于非脂肪肝组。相比正常对照组,肥胖、中心性肥胖和高脂血症分别增加脂肪肝患病风险15.2倍、10.8倍和8.6倍(P<0.01)。多元回归分析发现,女性、BMI、SBP、三酰甘油、HDL-C、LDL-C、TC、ALT、GGT等9项指标与脂肪肝密切相关。结论上海市社区60～64岁人群脂肪肝患病率较高,与肥胖及脂代谢紊乱密切相关。

Objective To investigate the prevalence and major risk factors of fatty liver disease in elderly population of Shanghai community. Methods A total of 7534 residents aged 60 and above who came from Meilong community of Minhang District were enrolled to participate in the survey. They underwent regular physical examination, laboratory tests and ultrasonographic examination. Results Among the 7 534 residents 4 198 were females and 3 336 were males with a F/M ratio of 1. 26. The mean age of the participants was 68.8± 7.0 years. Fatty liver was detected with ultrasound examination in 3 074 participants（40.80G）. The prevalence of fatty liver in Shanghai elderly declines with the increment of age. Ages ranging from 60 to 64 have the highest prevalence of 45.20%. The prevalence of fatty liver in males was significantly higher than that in males younger than 80 years. The mean body mass index（BMl）, waist circumference,waist hip circumference ratio（WHR）, triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, systolic blood pressure（SBP）, alanine aminotransferase （ALT） and y glutamyl transferase（GGT） in the fatty liver group were significantly higher than those in the group without fatty liver, but the high-density lipoprotein cholesterol （HDL-C） level was lower in the fatty liver group. Obesity, central-obesity and hyperiipidemia increased the risk for fatty liver by 15. 2-fold, 10. 8 fold and 8. 6-fold, respectively （P〈0. 001 ）, Logistic regression analysis demonstrated that the prevalence of fatty liver was positively correlated to nine risk factors, including female sex, BMI, SBP, HDL-C, LDL-C, TG, TC, ALT and GGT. Conelusion There is a high prevalence of fatty liver among community elderly in Shanghai, to which overweight and hyperlipidemia are closely relevant.