老年男性非酒精性脂肪性肝病相关因素研究

Risk Facters of Non-alcoholic Fatty Liver Disease in Elderly Men

目的探讨老年男性非酒精性脂肪性肝病(NAFLD)的相关因素。方法选取2011年4—8月在我院体检的老年(年龄≥60岁)男性1 043例。超声检查发现242例脂肪肝患者,其中164例诊断为NAFLD(NAFLD组);另从体检者中选取超声检查无脂肪肝的老年男性72例为对照组。分析比较NAFLD组及对照组的临床特征和实验室检查结果,并对其相关因素进行多因素非条件Logistic逐步回归分析。结果 NAFLD组总胆固醇、高密度脂蛋白、载脂蛋白A1、载脂蛋白B及血白细胞计数与对照组比较,差异均无统计学意义(P>0.05);而两组体质指数、收缩压、舒张压、空腹血糖及三酰甘油比较,差异均有统计学意义(P<0.01)。NAFLD组肥胖或超重、高血压、高三酰甘油血症和高血糖患病率与对照组比较,差异均有统计学意义(P<0.05)。多因素非条件Logistic逐步回归分析(进入法)显示,体质指数〔OR=1.449,95%CI(1.237,1.697),P=0.000〕、空腹血糖〔OR=2.188,95%CI(1.353,3.537),P=0.001〕及三酰甘油〔OR=2.213,95%CI(1.353,3.621),P=0.002〕进入回归方程。结论肥胖或超重、高血糖、高三酰甘油血症是NAFLD患者的主要危险因素。控制血脂、血糖和减重是防治NAFLD的重点,改善生活方式才是防治NAFLD的关键。

Objective To investigate the risk factors of non -alcoholic fatty liver disease （NAFLD） in elderly men. Methods Among 1 043 elderly （ 〉160 years） men who received health check - up in our hospital from April to August 2011, 242 were diagnosed with fatty liver by abdominal ultrasound, of which 164 were NAFLD （NAFLD group）. Another 72 healthy subjects were randomly selected as the control group. The clinical features and laboratory findings were compared between two groups. The potential risk factors of NAFLD were analyzed by non - conditional Logistic stepwise regression analysis. Results The levels of total cholesterol, high- density lipoprotein, apo A1, apo B, and white blood cell were not significantly different between these two groups （P 〉 0.05）, whereas the body mass index （BMI）, systolic blood pressure, diastolic blood pressure, fasting plasma glucose （FBG） and triglycerides showed significant differences （P 〈 0. 01 ）. The prevalences of obesity/over- weight, hypertension, hypertriglyceridemia, and hyperglycemia were a/so significantly different between these two groups （P 〈 0. 01 ）. Non - conditional logistic stepwise regression analysis showed that BMI [ OR = 1. 449, 95% CI （ 1. 237, 1. 697）, P = 0.0003, FBG （OR= 2. 188, 95%CI （1.353, 3. 537）, P=0.0013. and triglyceride [OR=2.213, 95%CI （1.353, 3. 621 ）, P = 0. 0021 were the risk factors of NAFLD. Conclusion The main risk factors of NAFLD include hypertriglyceridemia, hyperglycemia and obesity/overweight. Lowering plasma lipids and plasma glucose and weight loss by adopting healthy lifestyle are critical in the prevention and treatment of NAFLD.