老年非酒精性脂肪肝与慢性代谢性疾病的相关性

Association between Nonalcoholic Fatty Liver and Chronic Metabolism Dysfunctions in Senile Patients

目的探讨老年患者非酒精性脂肪肝(NAFL)与血尿酸(UA)等代谢指标的相关性。方法选择2008年1月至2010年12月在北京军区总医院的住院患者427例,年龄67～89(75.3±12.1)岁,男332例,女95例,分为非脂肪肝组和NAFL组,分析两组患者血UA水平和其他代谢指标(转氨酶、血糖、体质量指数、血脂、肾功能及糖尿病、高血压病、冠心病)对其发病的影响。结果两组间比较NAFL组的UA、丙氨酸氨基转移酶(ALT)、血糖、体质量指数(BMI)、三酰甘油(TG)均高于非脂肪肝组;低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)低于非脂肪肝组;NAFL组糖尿病、冠心病的发病率高,差异均有统计学意义(均P<0.05)。以脂肪肝为因变量,Logistic回归分析显示,糖尿病、吸烟、GPT高、肌酐低、UA高是脂肪肝的危险因素,上述因素均与脂肪肝呈正相关(P<0.05)。结论 NAFL患者的UA、TG、BMI高,糖尿病、冠心病的发病率高;而LDL-C低。预防脂肪肝应重视控制血糖、血压、血脂、体质量、UA等危险因素。

Objective To observe the association between nonalcoholic fatty liver and serum uric acid（UA）and other metabolism dysfunctions in senile patients.Methods A total of 427 patients,with age of 67-89（75.3 ±12.1）years old,male 332 cases,female 95 cases were collected.The patients were divided into two groups：nonalcoholic fatty liver（NAFL）group and non fatty liver group.The association of serum UA and other metabolism dysfunctions（liver function,blood glucose,higher body mass index,blood lipids,renal function and diabetes mellitus,hypertensive disease,coronary heart disease）were analyzed for the two groups.Results NAFL group had significantly higher levels of UA,BMI,higher alanine aminotransferase（ALT）,higher blood glucose,higher triglyeride than non fatty liver group（P0.05）,but lower creatinine（Cr）and low density lipoprotein cholesterol（P0.05）.Logistic regression with NAFL as the dependent variables showed that NAFL was positively correlated with,diabetes mellitus,smoking,high GPT,low creatinine,and high UA.Conclusion NAFL patients have higher UA,TG,and BMI,and higher incidence of diabetes mellitus and coronary artery disease,but lower LDL-C.Therefore the control of the risk factors such as blood sugar,blood pressure,blood lipids,body mass,and UA should be paid due attention to prevent fatty liver.