青年冠心病患者合并非酒精性脂肪性肝病危险因素研究

Risk factors of non-alcoholic fatty liver disease in young patients with coronary heart disease

目的探讨青年冠心病患者非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的患病率和危险因素。方法冠状动脉造影诊断为冠心病的青年患者718例,根据肝胆超声检查结果分为NAFLD组(358例)与非NAFLD组(360例),比较2组临床资料、血脂水平及冠状动脉病变程度,采用多因素logistic回归分析青年冠心病NAFLD的危险因素。结果 NAFLD发生率为49.9%;NAFLD组合并糖尿病比例、体质量指数、空腹血糖、血清总胆固醇、三酰甘油、谷丙转氨酶、谷草转氨酶水平及多支病变比例高于非NAFLD组,差异有统计学意义(P<0.05);多因素logistic回归分析显示,糖尿病和三酰甘油水平是青年冠心病NAFLD的独立危险因素。结论青年冠心病患者NAFLD发病率较高,糖尿病、高甘油三酯血症是其伴发NAFLD的重要危险因素。

Objective To investigate the incidence and risk factor of non-alcoholic fatty liver disease （NAFLD） in young patients with coronary artery disease. Methods A total of 718 young patients with angiographically confirmed coronary artery disease were divided into NAFLD group （n = 358） and non-NAFLD group （n = 360） according to the ultrasonography results, and were compared the clinical data, blood lipid levels and severities of coronary artery disease between two groups. Multivariate logistic regression analysis was used to analyze the risk factors of coronary heart disease in young NAFLD patients. Results The incidence of NAFLD was 49.9G. The proportion of diabetes mellitus, body mass index, fasting plasma glucose, serum total cholesterol, triacylglycerol, glutamic-pyruvic transaminase, glutamic-oxaloacetic transaminase levels and proportion of multi-vessel lesion were higher in NAFLD group than those in non-NAFLD group （P 〈0.05 ）. Multivariable logistic regression analysis revealed diabetes mellitus and high triacylglycerol level were the risk factors for NAFLD in young patients with coronary heart disease. Conclusions The young patients with coronary artery disease have a high incidence of NAFLD, and diabetes mellitus and hypertriglyceridemia are the important risk factors for NAFLD.