广东省农村社区居民脂肪肝流行病学调查

Epidemiological survey on fatty liver in rural area of Guangdong province

目的了解广东省农村社区居民脂肪肝患病情况及其影响因素。方法采用多阶段抽样方法抽取广东省农村社区7岁以上常住居民2 043人进行问卷、查体和实验室检查,包括吸烟饮酒、饮食状况、体格检查、肝脏B超以及生化检测。结果共检出脂肪肝264人,患病率为12.9%（男性为13.7%,女性为12.5%）;酒精性脂肪肝、疑似酒精性脂肪肝和非酒精性脂肪肝的患病率分别为0.5%,1.3%和11.1%;随着年龄的升高脂肪肝患病率升高,50岁以前男性的患病率高于女性（χ^213.985,P〈0.001）;儿童青少年（7～18岁）脂肪肝患病率为1.4%（5/367）,皆为非酒精性脂肪肝,成人（18岁及以上）脂肪肝患病率为15.5%,酒精性、疑似酒精性、非酒精性脂肪肝患病率分别为0.66%,1.61%,13.19%;按年龄、性别标准化后广东省农村脂肪肝7岁及以上人口患病率为10.54%,酒精性、疑似酒精性、非酒精性脂肪肝的标化率分别为0.55%,1.52%和8.34%;广东省农村成人脂肪肝标化率为13.81%（酒精性、疑似酒精性、非酒精性脂肪肝的标化率分别为0.74%,2.1%和10.95%）。广东省农村成人脂肪肝病因单因素分析结果表明,年龄、性别、文化程度、饮酒、饮食口味偏咸、超重、肥胖、高血压、腰臀比、腰围以及血液化验指标甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和血糖与脂肪肝发生有关。多因素非条件Logistic回归分析结果显示,除了年龄、性别与脂肪肝有关外,饮酒、饮食口味偏咸、体质指数、腰围、腰臀比、血清甘油三酯、空腹血糖以及高血压等指标与脂肪肝有关。结论广东省农村居民脂肪肝主要为非酒精性脂肪肝,成人脂肪肝主要与饮酒、饮食和多元代谢紊乱关系密切。

Objective To investigate the prevalence and major risk factors of fatty liver among the general population in rural area of Guangdong province. Methods 2 043 residents aged 7 years and above were selected by multi-stage sampling in Guangdong province. Questionnaire about smoking, alcohol consumption, diet, physical examination, liver ultrasonography and serological tests were carried out. Results A total of 264 residents were detected with fatty liver which prevalence was 12.9% （male 13.7 %, female 12.5 % ）, the prevalence of alcoholic fatty liver, suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.5 %, 1.3 % and 11.1% respectively. The prevalence of fatty liver was increased with the age in males and females. Among participants younger than 50 years old, the prevalence of fatty liver in males was significantly higher than that in females（x^2 = 13.985, P〈0.001）.The prevalence of fatty liver in children（7- 18 years old） was 1.4% （5/367）, all of them were nonalcoholic fatty liver, while the prevalence of fatty liver in adults was 15.5 %, the prevalence of alcoholic fatty liver, suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.66 %, 1.61% and 13.19 % respectively. After being adjusted for age and sex, the standardized prevalence of fatty liver in 7 years and above was 10.54 %, the standardized prevalence of alcoholic fatty liver, suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.55 %, 1.52 % and 8.34 % respectively. The standardized prevalence of fatty liver in adults was 13.81%, the standardized prevalence of alcoholic fatty liver, suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.74 %, 2.1% and 10.95 % respectively. Risk factors associated with fatty liver in rural adults of Guangdong province with single variate analysis demonstrated that risk factors such as the age, sex, education level, drinking, diet, body mass index （BMI）, waist circumference（WC）, waist hip ratio（WHR）, blood pressure, fasting serum glucose, triglyceride （TG）, total cholesterol （TC） , high- and low- density lipoprotein cholesterol level were related to fatty liver. Logistic regression analysis demonstrated that female, educational level were protective factors of fatty liver while risk factors such as drinking, salty favor, BMI, WC, WHR, TG, fasting serum glucose and hypertension were positively correlated to fatty liver. Conclusion The major type of fatty liver in rural area of Guangdong province is non-alcoholic fatty liver, alcoholic consumption, diet and metabolic disorders are closely associated with fatty liver in rural adults of Guangdong province.