中国汉族丙型肝炎患者代谢综合征患病率及危险因素分析

The prevalence and risk factors of metabolic syndrome among hepatitis C patients in Chinese Han population

目的评估中国汉族丙型肝炎患者中代谢综合征的患病率及其危险因素。方法本研究为一项多中心、横断面研究。纳入997例中国汉族丙型肝炎感染者。采集人口统计学、人体测量数据及代谢综合征相关临床指标。统计学处理采用t检验(正态分布)或Mann-WhitneyU双样本检验(非正态分布)和卡方检验。与代谢综合征显著相关的因素进一步采用二元logistic回归分析。结果997例丙型肝炎患者中,170例(17.1%)患者被诊断为代谢综合征。二元logistic回归分析显示,基因2型(OR=1.594;95%CI:1.045~2.431,P=0.030)、高龄(OR=1.040;95%CI:1.022~1.058,P<0.01)、超重(OR=3.876;95%CI:2.593~5.792,P<0.01)、脂肪肝病史(OR=2.106;95%CI:1.384~3.204,P=0.001)、稳态模型胰岛素抵抗指数(OR=1.263;95%CI:1.118~1.427,P<0.01)、空腹胰岛素低水平(OR=0.949;95%CI:0.915~0.985,P=0.006)、低血清白蛋白水平(OR=0.957;95%CI:0.915~1.000,P=0.049)和高γ-谷氨酰转肽酶水平(OR=1.004;95%CI:1.000~1.008,P=0.0041)与代谢综合征的存在具有显著相关性。结论对基因2型、高龄、超重、有脂肪肝病史、稳态模型胰岛素抵抗指数偏高、空腹胰岛素水平偏低、血清白蛋白偏低、高γ-谷氨酰转肽酶水平的丙型肝炎患者,要重视代谢综合征的筛查。

Objective To evaluate the prevalence and risk factors of metabolic syndrome among hepatitis C patients in Chinese Han population. Methods This was a multicenter, cross-sectional study. A total of 997 Chinese Han patients with hepatitis C virus (HCV) infection were enrolled. Demographic data, anthropometric data and clinical parameters related to metabolic syndrome were collected. Statistical analysis was performed by t-test (normal distribution) or Mann-Whitney U two-sample test (non-normal distribution) and χ2 test. Binary logistic regression analyses were used to determine the parameters significantly related to metabolic syndrome. Results Among the 997 patients, 170 (17.1%) patients were diagnosed with metabolic syndrome. Binary logistic regression showed that genotype 2 (OR=1.594; 95%CI: 1.045-2.431, P=0.030), older age (OR=1.040; 95%CI: 1.022-1.058, P<0.01), overweight (OR=3.876; 95%CI: 2.593-5.792, P<0.01), fatty liver history (OR=2.106; 95%CI: 1.384-3.204, P=0.001), homeostasis model assessment insulin (HOMA-IR) (OR=1.263; 95%CI: 1.118-1.427, P<0.01), fasting insulin (OR=0.949; 95%CI: 0.915-0.985, P=0.006), lower serum albumin level (OR=0.957; 95%CI: 0.915-1.000, P=0.049) and higher γ-GT level (OR=1.004; 95%CI: 1.000-1.008, P=0.0041) were all significantly associated with the presence of metabolic syndrome. Conclusions Hepatitis C patients with genotype 2, older age, overweight, fatty liver history, higher HOMA-IR, lower fasting insulin level, lower serum albumin level or higher γ-GT level should be screened for metabolic syndrome.