老年非酒精性脂肪肝患者外周血管病变的危险因素研究

Research on Risk Factors for Peripheral Vascular Lesions in Elderly Patients with Non-Alcoholic Fatty Liver Disease

目的探讨老年非酒精性脂肪肝(NAFLD)患者外周血管病变(PVD)的危险因素。方法回顾性分析97例老年NAFLD合并PVD患者及35例外周血管正常患者的临床资料,分析纳入患者PVD与年龄、性别、血压、吸烟、体质指数(BMI)、腹围、血脂、血糖、胰岛素抵抗指数(HOMA-IR)、C反应蛋白(CRP)、肝纤维化BAAT评分及脂联素的相关性。结果老年NAFLD患者踝臂指数(ABI)与年龄、收缩压、CRP呈正相关,而与脂联素呈负相关(P<0.01);血管斑块面积与年龄、低密度脂蛋白(LDL)、HOMA-IR呈正相关,而与高密度脂蛋白(HDL)呈负相关(P<0.01);血管斑块厚度与年龄、收缩压、腹围、CRP、HOMA-IR呈正相关,而与HDL、脂联素呈负相关(P<0.05)。多因素回归分析显示,年龄、LDL、CRP、脂联素是老年NAFLD患者发生PVD的危险因素。结论LDL、CRP升高及脂联素下降可能是老年NAFLD患者发生PVD的中心环节。

Objective To investigate the risk factors for peripheral vascular lesions in elderly patients with non-alcoholic fatty liver disease（NAFLD）.Methods Clinical data of 97 elderly NAFLD patients with peripheral vascular disease and 35 elderly NAFLD patients with normal peripheral vessel were retrospectively analyzed.Correlation between PVD and age,sex,blood pressure,smoking,body mass index（BMI）,waist circumference,blood lipids,blood glucose,insulin resistance index（HOMA-IR）,C-reactive protein（CRP）,liver fibrosis BAAT score and adiponectin was analyzed.Results In elderly NAFLD patients,the ABI was positively correlated with age,systolic blood pressure and CRP,but was negatively correlated with adiponectin（P0.01）.The blood vessel plaques area was positively correlated with age,low density lipoprotein（LDL） and HOMA-IR,but was negatively correlated with HDL（P0.01）.The thickness of blood vessel plaque was positively correlated with age,systolic blood pressure,waist circumference,CRP and HOMA-IR,but was negatively correlated with HDL and adiponectin（P0.05）.Multiple regression analysis showed that age,LDL,CRP and adiponectin were risk factors for NAFLD patients with PVD.Conclusion Increased LDL,CRP and decreased adiponectin may be key risk factors for elderly NAFLD disease with peripheral vascular disease patients.