深圳市中高层职业人群腰臀比值、体重指数与脂肪肝的相关性研究

The Relationship Between WHR, BMI and Risk Factors of Hepatic Steatosis in People From Middle to High Socio-economic Class in Shenzhen

目的探讨深圳市中高层职业人群腰臀比值、体重指数与肥胖、高脂血症、脂肪肝等的相关性及流行病学特征。方法对2004年9月～2005年8月深圳市企事业单位中高层职业人群1515例健康体检者进行身高、体重、腰围、臀围、腹部B超、血脂等检测，并按腰臀比值、体重分层分析各组与肥胖、高脂血症脂肪肝等的相关性及流行病学特征。结果受检者肥胖患病率为27．9％，超重者患病率为21．6％，中心性肥胖患病率为24．8％。高脂血症患病率为55．25％（男性：63．89％，女性：39．78％），脂肪肝患病率为21．19％（男性：28．09％，女性：8．84％）。中心性肥胖组（按WHR分型）和外周型肥胖组（按BMI分型）的高脂血症、脂肪肝的检出率明显高于正常体型和正常体重组（P〈0．01）。中心性肥胖的高脂血症、脂肪肝患病率的检出率明显高于外周肥胖（P〈0．01）。中心性肥胖与外周肥胖都与高脂血症、脂肪肝的患病率呈正相关（P〈0．01）。结论深圳市中高层职业人群肥胖、高脂血症和脂肪肝的患病率明显增高，尤其是高脂血症值得关注。肥胖、高脂血症是导致脂肪肝的独立危险因素，中心性肥胖比外周型肥胖危险性更大。腰臀比值与体重指数都可作为脂肪肝的危险预测因素，腰臀比值比体重指数特异性更高，两者结合进行可明显提高脂肪肝风险预测的特异性和敏感性。

Objective To discuss the relationship and the epidemiological characteristic between WHR, BMI and obesity, hyperlipideamia, hepatic steatosis in people from middle to high socio - economic class in Shenzhen. Methods 1 515 managers in Shenzhen enterprise from September 2004 to August 2005 were divided into groups by WHR and BMI, then checked up with height, weight, waist circumference, hip circumference, liver ultrasonic and blood lipid. The relationship and epidemiological characteristics between each group and obesity, hyperlipideamia, hepatic steatosis were analyzed. Results The prevalence of obesity is 27.6%, overweight is 21.4%, and abdominal adiposity is 24. 8%. The prevalence of hyperlipideamia is 55. 25% （ male： 63. 89%, female： 39. 78% ）, hepatic steatosis is 21.19% （male： 28. 09%, female： 8.84% ） . Hyperlipideamia and hepatic steatosis in abdominal adiposity group （ were divided by WHR） and visceral adiposity group （ were divided by BMI） were examined more than normal weight group （ P 〈 0. 01 ） . Abdominal adiposity have a significant with the prevalence of hyperlipideamia and hepatic steatosis than visceral adiposity （P 〈 0. 01 ） . Both abdominal adiposity and visceral adiposity were found positively related with hyperlipideamia and hepatic steatosis （P 〈 0. 01 ） . Conclusion The prevalence of obesity and hepatic steatosis in people from middle to high socio - economic class in Shenzhen has shown a significant increment, hypefiipideamia in particular. Obesity and hyperlipideamia are predominant factors to conduce hepatic steatosis. Abdominal adiposity is a stronger risk factor compare with visceral adiposity. The specificity and sensitivity of diagnosing hepatic steatosis are significantly higher by using WHR than by BMI.