男性非酒精性脂肪性肝病危险因素分析

Risk factors analysis of nonalcoholic fatty fiver disease in Chinese men

目的探讨男性非酒精性脂肪性肝病（NAFLD）的危险因素，为NAFLD的防治提供理论依据。方法研究对象为厦门大学附属东南医院肝病中心住院的102例男性NAFLD患者为NAFLD组，选取同期健康体检正常的23例男性为对照组，采用单因素和多因素logistic回归分析方法，比较两组人体质量指数（BMI）、腰围（WC）、腰臀比（WHR）、空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）与男性NAFLD的相关性，绘制受试者工作特征曲线（ROC曲线），以寻找判别临界点。用SPSS13．0软件进行统计学处理，组间对比用成组t检验。危险因素分析采用单因素和多因素logistic回归分析。结果BMI、WC、WHR、FPG、TG、TC，NAFLD组分别为（26．85±3．88）kg／m2、（91．2±7．0）cm，0．92±0．04、（5．37±1．43）mmol／L、（2．29±1．83）mmol／L和（5．10±1．26）mmol／L；对照组分别为（20．73±2．65）kg／m2、（81．6±7．4）cm、0．86±0．05、（5．01±2．66）mmol／L、（1．25±0．94）mmol／L和（4．24±1．63）mmol／L；t值分别是-6．442、5．895、7．452、-3．634、-4．114和2．624，P值均〈0．01，差异均有统计学意义。BMI、WC、WHR、TG、TC均为男性NAFLD的危险因素（P〈0．01），BMI在预测男性NAFLD发生上最有价值（G冗：10．819），WHR次之（OR=10．588）。结论BMI、WC、WHR、TG、TC是男性NAFLD的危险因素，BMI、wHR预测男性NAFLD的价值最高。

Objective To explore risk factors of nonalcoholic fatty liver disease （NAFLD） in men in order to provide a theoretical basis for developing more effective NAFLD prevention and control strategies. Methods One-hundred-and-two male patients （37.3 ± 11.4 years old） hospitalized with NAFLD at the Dongnan Affiliated Hospital of Xiamen University between January 2009 and December 2010 were enrolled in the study, along with 23 age-matched healthy men （34.4 ± 16.7 years old） to serve as the control group. The correlation（s） of body mass index （BMI; overweight defined as ≥ 22.717 kg/m2）, waist circumference （WC）, waist-to-hip ratio （WHR; central obesity defined as ≥ 0.866）, fasting plasma glucose （FPG）, triglyceride （TG）, and total cholesterol （TC） with NAFLD was analyzed by univariate and multivariate logistic regression analyses. Receiver operating characteristic （ROC） curves were used to select proper thresholds for classification. Results BMI, WC, WHR, FPG, TG, and TC were significantly different between the cases and controls （P 〈 0.01）. BMI, WC, WHR, TG and TC were identified as risk factors of NAFLD in these male cases （P 〈 0.01）. Relative to WC, TG and TC, both BMI and WHR had significant predictive value for NAFLD （odds ratio （OR） = 10.819 and 10.588, respectively）. In addition, BMI had the highest diagnostic value for the prediction of NAFLD （area under the curve （AUC） = 0.931） followed by WHR （AUC = 0.879）. Conclusion BMI, WC, WHR, TG, and TC are risk factors of NAFLD in Chinese men. BMI and WHR are effective anthroposomatology indices of NAFLD and may be useful factors on which to base future prevention and early diagnosis strategies for NAFLD in males.