城市社区中老年人群非酒精性脂肪肝与糖尿病、冠心病患病的现况

Prevalence and risk factors of non-alcoholic fatty liver disease in urban community elder residents

目的:探讨城市社区内中老年人群中脂肪肝与糖尿病、冠心病、高血压患病分布特点及脂肪肝患病的相关影响因素.方法:收集广州市参加集体体检的某社区1 795个居民的体检资料,比较脂肪肝与高血压、糖尿病及冠心病在人群分布的特点,以及人群的体质量指数(BMI)、尿酸(UA)、血清胆固醇(TC)、甘油三酯(TG)、谷丙转氨酶(ALT)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、吸烟、饮酒、清淡饮食、脂肪肝家族史等指标与脂肪肝发病的关系.结果:年龄标化后脂肪肝检出率为24.75%,其中男性29.15%,女性为22.76%.糖尿病患病率为7.83%,高血压患病率为22.38%,冠心病患病率为6.81%;在确诊有高血压的患者中检出伴有脂肪肝的比例高达36.3%(OR=2.090)、糖尿病患者中检出伴有脂肪肝的比例为45.0%(OR=2.602),冠心病患者中伴有脂肪肝的比例为33.1%(OR=1.526);采用Logistic回归模型进行多因素分析,BMI、FBG、TG、糖尿病、冠心病、运动和脂肪肝家族史与脂肪肝患病有显著相关性.结论:脂肪肝与高血压、高血糖、冠心病等心脑血管病有并存的倾向;BMI、FBG、TG、糖尿病、冠心病及脂肪肝家族史与脂肪肝患病有显著正相关性,运动是脂肪肝的保护性因素,社区慢病管理中需要更多关注脂肪肝的防治.

Aim：To study relation between distribution characters of the fatty liver with diabetes,coro-nary heart disease,hypertension,and related influence factors of fatty liver in middle-aged and old peo-ple in urban community.Methods：It has been collected which include relevant medical data of 1 795 residents who participated in collective medical physical examination,and which also include the historys of smoking,drinking,bland diet,high blood pressure,diabetes and coronary heart disease,family histo-ry of fatty liver and other indicators with fatty liver disease.Results：The standardized prevalence rate of fatty liver was 24.75%,（29.1 5% in men and 22.76% in women）.Diabetes prevalence was 7.83%, hypertension prevalence rate was 7.83%,the incidence of coronary heart disease was 6.81%;Detection in the patients with fatty liver accompanied by high blood pressure was up to 36.3%（OR=2.090）.De-tection in the patients with fatty liver accompanied by diabetes was up to 45.0%（OR=2.602）.Detec-tion in the patients with fatty liver accompanied by coronary heart disease （CHD）was 33.1% （OR=1.526）;The available data were analyzed by multi-factorial non-conditional Logistic regression method. Seven factors were identified,i.e.BMI,FBG,TG,family history of diabetes,coronary heart disease, movement and family history of fatty liver.Conclusion：Fatty liver and high blood pressure,high blood sugar,cardio-cerebrovascular disease such as coronary artery disease tend to coexist.BMI,FBG,TG, family history of diabetes,coronary heart disease,and fatty liver and fatty liver disease have a significant positive correlation separatively,motionis protective factors of fatty liver.more attention need to be paid to the prevention and cure of fatty liver in chronic disease management.