高尿酸血症对非酒精性脂肪肝患者代谢异常的影响及其与动脉硬化的关系

Effect of hyperuricemia on metabolic abnormalities and its relationship with atherosclerosis in pa-tients with non-alcoholic fatty liver disease

目的研究健康体检人群非酒精性脂肪肝（NAFLD）和高尿酸血症（HUA）检出率，探讨高尿酸血症对非酒精性脂肪肝患者代谢异常的影响及其与动脉粥样硬化的关系。方法通过健康体检人群1286例进行横断面研究。将非酒精性脂肪肝患者分为正常尿酸组和高尿酸血症组，观察两组代谢异常及其颈动脉粥样硬化情况，多因素Logistic回归分析非酒精性脂肪肝患者颈动脉硬化的危险因素。结果健康体检人群中非酒精性脂肪肝检出率为39．81％，高尿酸血症检出率为15．24％，NAFLD组较无NAFLD组高尿酸血症检出率明显增高，血尿酸水平比较差异有统计学意义；非酒精性脂肪肝患者高尿酸血症组收缩压（SBP）、舒张压（DBP）、体质量指数（BMI）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL—C）、空腹血糖（FBG）、以及代谢综合征各组分、代谢综合征发病率高于正常尿酸组，HDL—C低于正常尿酸组，高尿酸血症对非酒精性脂肪肝患者IMT、颈动脉硬化类型有明显影响；经多因素Logistic回归分析，高尿酸血症、肥胖、高血压、高TG症、低HDL症、高血糖以及代谢综合征是非酒精性脂肪肝患者颈动脉硬化的危险因素。结论高尿酸血症加重非酒精性脂肪肝患者代谢异常，并且对颈动脉硬化有明显影响。

Objective To study non-alcoholic fatty liver disease （NAFLD） and hyperuricemia （HUA） detection rate in healthy populations, to evaluate the effect of hyperuricemia on metabolic abnormali-ties in patients with non-alcoholic fatty liver and its relationship with atherosclerosis. Methods A cross-sec-tional study on 1286 cases of healthy people was made, the non-alcoholic fatty liver patients were divided into normal uric acid group and hypenaricemia group. The metabolic abnormalities of the two groups and their ca-rotid atherosclerosis situation were observed, multivariate logistic analysis was used for the risk factors for ca-rotid atherosclerosis in patients with non-alcoholic fatty liver. Results In healthy populations, detection rate of non-alcoholic fatty liver was 39. 81%, hyperuricemia detection rate was 15. 24%, the hyperlipidemia detec-tion rate was significantly higher in NAFLD group than those in NO-NAFLD group. The blood uric acid levels also had significant differences. The SBP, DBP, BMI, TC, TG, LDL-C, FBG, metabolic syndrome compo- nents and metabolic syndrome of non-alcoholic fatty liver disease patients with hyperuricemia group were high-er than that in normal uric acid group, the level of HDL-C was lower than that in normal uric acid group. The IMT, carotid atherosclerosis type in patients with non-alcoholic fatty liver was significantly affected by hyperu- rieemia. By multivariate Logistic regression analysis, hyperuricemia, obesity, hypertension, high TG, low HDL, hyperglycemia, and metabolic syndrome were carotid atherosclerosis risk factors in patients with non-al-coholic fatty liver. Conclusions Hyperuricemia can aggravate metabolic abnormalities of patients with non-alcoholic fatty liver disease and it has significantly effect on carotid atherosclerosis.