丙氨酸氨基转移酶升高的老年人的临床特征与超声诊断脂肪肝的相关性

Clinical characteristics of elders with elevated alanine aminotransferase and its association with ultrasound diagnosis of fatty liver

目的评估丙氨酸氨基转移酶(ALT)升高的老年人的临床特征与脂肪肝的相关性。方法通过对2010年5月-2010年6月来我院行健康体检的1 054例老年体检者进行横断面研究,发现154例ALT升高,其中54例有乙型肝炎或者酒精摄入过量,最终100例入选本组研究。被分为非酒精性脂肪肝组(NAFLD)50例和对照组50例。分别进行体格检查计算体质量指数(BMI)、脂质代谢、ALT及糖尿病等调查。结果在100例患者中,超声诊断50%有非酒精性脂肪肝,与无脂肪肝的患者相比,非酒精性脂肪肝患者有糖尿病史(P=0.019),并有较高的BMI(P=0.013)和甘油三脂(P=0.022)。多变量回归分析显示BMI和糖尿病为脂肪肝的独立危险因素,BMI(OR=1.454;95%CI∶1.139～1.856;P=0.003)和糖尿病史(OR=3.378;95%CI∶1.343～8.494,P=0.01)。结论具有ALT升高且无病毒性肝炎的患者,通过临床表现如糖尿病史和高BMI可以预测出超声下非酒精性脂肪肝病的存在。

Objective To evaluate clinical characteristics associated withof elders with elevated alanine aminotransferase（ALT） and its association with ultrasound diagnosis of fatty liver.Methods The physical examination data of 1 054 elders were cross-sectionally analyzed from May.2010 to Jun.2012.There were 154 persons with elevated ALT,in which 54 cases were caused by hepatitis B and alcohol abuse.100 subjects were included into the present study.Subjects were divided into NAFLD group（50 cases） and control group（50 cases）.BMI,lipid metabolism,ALT,diabetes mellitus and so on were analyzed.Results In 100 cases of included individuals,50% were diagnosed as NAFLD using ultrasonography.Patients with NAFLD showed higher（BMI）（P=0.013）,diabetes prevalence（P=0.019） and triglycerides（P=0.022） compared with individuals without NAFLD.Multivariate regression analysis showed that BMI（OR=1.454;95% CI∶ 1.139~1.856;P=0.003） and diabetes mellitus（OR=3.378;95% CI∶ 1.343~8.494,P=0.01） were independent risk factor associated with NAFLD.Conclusion Clinical features such as history of diabetes and high BMI may predict the presence of NAFLD on ultrasonography inpatients with elevated ALT but negative hepatitis.