成年人脂肪肝与代谢综合征关系

Relationship between fatty liver disease and metabolic syndrome in adults

目的分析脂肪肝的危险因素,探讨脂肪肝(FLD)与代谢综合征(MS)的关系。方法对2006-2007年参加健康体检的成人1113人进行现况调查、体检、生化检验、肝胆脾实时B超检查;代谢综合征的诊断及代谢指标异常的阳性标准采用美国国家胆固醇教育计划成人治疗组第三次报告2005年修订版(ATPIII2005)。结果脂肪肝、代谢综合征的检出率分别为17.1%,9.0%,经年龄标准化后男性为20.5%,9.97%;女性为9.7%,8.54%;腰围(WC)、体质指数(BMI)、空腹血糖(FPG)、甘油三酯(TG)、收缩压(SBP)及舒张压(DBP)异常的阳性率FLD组明显高于非FLD且(P<0.01),OR值为2.80～19.5,前3位分别为BMI、WC、TG;以MS的5指标异常的阳性项数为聚集标志,≥1、≥2、≥3项情况下发生脂肪肝的危险度(OR值)分别为9.56,17.67,41.13;WC、FPG、TG、HDL-C、SBP、DBP异常的阳性率及FLD的检出率MS组明显高于非MS组(P<0.01),OR值为3.00～30.7,TG、WC、FPG位列前3位,FLD的OR值为10.7。结论肥胖、高甘油三酯、高血糖和高血压是脂肪肝的危险因素,肥胖是关键,危险因素聚集越多脂肪肝发病率越高;脂肪肝与代谢综合征有共同的危险因素;脂肪肝往往伴有代谢综合征。

Objective To explore the relationship between fatty liver disease（FLD） and metabolic syndrome（MS）.Methods A cross-sectional survey was carried out among 1 113 adults with questionaire survey,physical examination,biochemical inspection,and ultrasonic examination.The diagnosis of MS and its components followed the United States National Cholesterol Education Program-Adult Treatment Panel III-2005 revision（A T P III2005）.Results The prevalences of FLD and MS were 17.1% and 9.0% with the age-standardized prevalences of 20.05%,9.97% in men and 9.7%,8.54% in women.The positive rates of waist circumference（WC）,body mass index（BMI）,fasting plasma glucose（FPG）,triglyceride（TG）,systolic blood pressure（SBP）,and diastolic blood pressure（DBP） in FLD group were significantly higher than that of in non-FLD （P0.01）with the odds ratios （OR） of 2.80-19.5.The risk of fatty liver was inereased with the aggregation of components of MS.The value of OR for FLD was 9.56,17.67,and 41.13 for adults with ≥1,≥2,≥3 abnormal comporents of MS,respectively.The positive rates of WC,FPG,TG,high-density lipoprotein-cholesterol,SBP,DBP,and FLD in MS group were significantly higher than that of non-MS （P0.01）with the OR values of 3.00-30.7.Conclusion Obesity,high triglyceride,high blood sugar and high blood pressure are risk factors for fatty liver.Obesity is the key factor.The risk factors are positively correlated with the incidence of fatty liver.Fatty liver is an important risk factor for metabolic syndrome.