北京地区成年人血尿酸和非酒精性脂肪肝相关性研究

Association between Serum Uric Acid and Nonalcoholic Fatty Liver Disease in Beijng Adults

目的探讨北京地区成年人不同性别中血尿酸(UA)与非酒精性脂肪肝(NAFLD)的相关性。方法回顾性调查2010年1～10月在笔者医院接受健康体检的人员,共计2074例(男性1447例,女性627例)。脂肪肝采用B型超声进行检测。代谢综合征(MS)诊断标准采用美国国家胆固醇教育计划成人治疗方案第3次报告(NCEP-ATPⅢ)的中国人修订标准。结果男、女性NAFLD患病率分别为28.1%和21.9%(P<0.01)。按UA水平四分位数分组(Q1～Q4组)显示,随UA分组水平升高,男、女性NAFLD患病率皆呈趋势性升高。控制年龄和各种肝酶后,经多元Logistic回归分析显示,男性UA水平Q4较Q1发生NAFLD的OR(95%CI)值是1.57(1.10～2.22)倍;女性是3.96(1.92～8.14)倍;同时控制年龄、AST、ALT、GGT和MS等因素后,男性UA不再是NAFLD的独立危险因素(P>0.05),而女性UA依然是NAFLD的危险因素(P=0.001)。结论男、女性UA与NAFLD皆具有显著相关性。男性UA与NAFLD的相关性受到MS的影响,女性UA与NAFLD的相关性独立于MS。

Objective To investigate the direct association between serum uric acid （UA） and nonalcoholic fatty liver disease （NAFLD） in Beijng adults. Methods A retrospective sex - specific analysis was performed including 1447 men and 627 women in an annual health check - up program from January 2010 to October 2010 in Beijing. Fatty liver was diagnosed based on abdominal ultrasonog- raphy. The National Cholesterol Education Program - Adult Treatment Panel Ill criteria modified for Chinese subjects was used for diagno- sis of metabolic syndrome （ MS）. Results The prevalence of NAFLD was 28.1% in men and 21.9% in women （P 〈 0.01 ） , respective- ly. Stratified by quartiles of UA （ Q1 - Q4） , the prevalence of NAFLD were significantly increased along with increased UA levels in both genders. In multivariate logistic regression analysis, after adjustment for age and liver enzymes, comparing Q4 with Q1, the odd ratio （95% CI） of prevalence of NAFLD was 1.67 （ 1.10 - 2.22） in men, 3.96 （ 1.92 - 8. 14） in women, respectively. After adjustment for age, liver enzymes and MS, UA was closely associated with NAFLD in the women （P = 0. 001 ） , and there was no significant correlation between UA and NAFLD in men（P 〉 0.05）. Conclusion There was significant association between UA and NAFLD in both genders. The association between UA and NAFLD is dependent MS in men, while independent MS in women.