济南市女性膳食模式与非酒精性脂肪肝病关系

Association between dietary pattern and nonalcoholic fatty liver disease in female population in Ji'nan city

目的 探讨山东省济南市女性人群不同膳食模式与非酒精性脂肪肝病（NAFLD）的关系,为NAFLD的预防控制提供参考依据。方法 随机抽取2010年11月—2012年7月在济南市某三甲医院进行健康体检的1 354名女性进行膳食调查、体格检查和实验室检测;采用因子分析和多因素logistic回归模型分析主要膳食模式及其与NAFLD之间的关系。结果 济南市女性人群NAFLD患病率为8.4%;因子分析共得到鱼肉类模式、杂粮蔬菜类模式、油谷类模式、糕点饮料类模式、蛋奶类模式5种膳食模式,累积方差贡献率为50.54%;调整年龄和体质指数（BMI）后,多因素logistic回归分析结果显示,鱼肉类模式（OR=0.49,95%CI=0.28~0.87）和糕点饮料类模式（OR=1.84,95%CI=1.07~3.14）与NAFLD患病有关;进一步分析不同膳食模式与NAFLD关系,调整年龄和BMI后,结果显示,鱼肉类模式得分最高四分位数者患NAFLD的危险性为最低四分位数者的5.00倍（OR=5.00,95%CI=1.04~23.90）,油谷类模式得分第二四分位数者患NAFLD的危险性为最低四分位数者的0.38倍（OR=0.38,95%CI=0.16~0.90）,糕点饮料类模式得分第三分位数者患NAFLD的危险性为最低四分位数者的0.36倍（OR=0.36,95%CI=0.13~0.99）。结论 鱼虾类、畜禽肉类、糕点及饮料等食物摄入过多可增加女性患NAFLD的危险性。

Objective To explore the relationship between different dietary pattern and nonalcoholic fatty liver dis- ease （NAFLD） and to provide the reference for the prevention and control of NAFLD in female population of Ji＇ nan city. Methods Totally 1 354 women having a physical examination in a 3A grade hospital in Ji＇ nan from November 2010 to July 2012 were randomly selected for a dietary survey and anthropometric and biochemical measurements. Factor analysis and multivariate logistic regression model were used to analyze the association of dietary patterns with NAFLD. Results The detection rate of NAFLD in the female population was 8.4%. Five dietary patterns, namely meat and fish, grains and vegetable, oil cereals, pastries beverage, and eggs and milk pattern, were identified through factor analysis, with a cu- mulative variance contribution rate of 50. 54%. After adjusting for age and body mass index（ BMI）, multiple logistic re- gression analysis showed that meat and fish pattern（ odds ratio[ ORI = 0.49,95% confidence interval[ 95% CII ：0. 28 - 0. 87） and pastries beverages pattern（ OR = 1.84,95% CI = 1.07 - 3.14） were associated with NAFLD. Furthermore, di- etary pattern scores were categorized into quartiles to conduct multivariate logistic regression analysis. After adjustment for age and BMI, the results displayed that the females in the highest quartile for the meat and fish dietary pattern had a 5.00 times greater odds of NAFLD（ OR =5.00,95% CI 1.04 -23.90）compared with those in the lowest quartile. The females in the second quartile of oil cereals pattern scores had a lower risk of NAFLD（ OR = 0. 38,95% CI = 0. 38 - 0. 90） compared to those in the lowest quartile of the score. The females in the third quartile of pastries beverage pattern scores had a lower risk of NAFLD（ OR = 0. 36,95% Cl = 0. 36 - 0. 99 ） compared to those in the lowest quartile of the score. Conclusion Excessive intake of fish and shrimp, poultry meat, cakes and beverages may increase the risk of NAFLD in female population.