非酒精性脂肪肝性别之间血清生化指标比较

Comparison of the Serum Biochemical Marks between Male and Female Nonalcoholic Fatty Liver Patients

目的比较非酒精性脂肪肝患者性别之间生化代谢差异，探讨预防控制策略。方法检测973名体检者的总蛋白（TP）、白蛋白（ALB）、球蛋白（GLO）、天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）、葡萄糖（GLU）、总胆固醇（T-CHO）、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）、载脂蛋白A1（apoA1）、载脂蛋白B100（apoB100），计算non-HDL-C、apoB100／apoA1、LDL-C／HDL-C、apoB100／HDL-C、TC／HDL-C比值，并对89例非酒精性脂肪肝与202名体检健康者（对照组）进行比较。结果脂肪肝患病率为9．05％，男性患病率12．53％，显著高于女性的6．0％（P〈0．05）；与对照组比较，59例男性患者的ALT、IBIL、TG、HDL-C、LDL-C、apoA1、non-HDL-C、apoB100／apoA1、LDL-C／HDL-C、apoB100／HDL-C、TC／HDL—C差异有统计学意义（P〈0．05，P〈0．01）．30例女性患者的AST、TBIL、DBIL、IBIL、GLU、T-CHO、TG、LDL—C、apoA1、non-HDL-C、apoB100／apoA1、LDL-C／HDL-C、apoB100／HDL-C、TC／HDL-C差异具有统计学意义（P〈0．05，P〈0．01）；non-HDL—C与TC、LDL—C、TG、HDL—C、apoA1、apoB100、apoB100／apoA1、TC／HDL均显著相关（相关系数0．4113—0．9893，P〈0．01）。结论非酒精性脂肪肝普遍具有代谢异常和肝脏受损特点，且性别之间表现不同，应采取针对性措施进行必要的预防和干预。

[ Objective] To compare the differences of biochemical metabolism between male and female nonalcoholic fatty liver patients and explore preventive countermeasures. [ Methods] Detection was made on the levels of TP, ALB, GLO, AST, ALT, TBIL, DBIL, IBIL, GLU, T CHO, TG, HDL C, LDL C, apoA1 and apoB 100 among 973 people who undertook physical examination; calculation was made on non HDL C and the ratio of apoB 100/apoA1, LDL C/HDL C, apoB 100/HDL C and TC/HDLC; comparison was made on the result between 59 nonalcoholic fatty liver patients and 202 healthy people in the control. [ Results] The total morbidity of fatty liver was 9.05% , the rate of the male patients was 12.53% , which was significantly higher than that of the female ones （ 6.0% ） （ P 〈 0.05 ） ; significant difference was found among the 59 male patients in the levels of ALT, IBIL, TG, HDL C, LDL C, apoA1, non HDL C and the ratio of apoB 100/apoA1, LDL C/HDL C, apoB 100/HDL C and TC/HDLC （ P 〈 0.05, P 〈 0.01 ） ; significant difference was also found among the 30 female patients in the levels of AST, TBIL, DBIL, IBIL, GLU, T CHO, TG, LDL C, apoA 1, non HDL C, and the ratios of apoB100/apoA1, LDL C/HD C, apoB 100/HDLC and TC/HDLC （ P 〈0.05, P 〈0.01 ） ; non HDL C was obviously correlated with TC, LDLC, TG, HDLC, apoA1, apoB100, apoB100/apoA1 and TC/FIDLC （ r =0. 4113 - 0. 9893, P 〈 0.01）. [ Conclusion] Metabolism disorder and liver damage are the common features of nonalcoholic fatty liver and there are significant differences between males and females; effective measure should be taken for the prevention and interference.