中老年非酒精性脂肪肝患者临床特点及其与血脂、血尿酸水平的相关性分析

The characters of nonalcoholic fatty liver disease and the related risk factors with blood lipid and serum uric acid

目的 探讨中老年非酒精性脂肪肝（NAFLD）患者临床特点及其与血脂、血尿酸水平的相关性。方法 选择2012年5月-2014年3月经超声诊断为NAFLD患者120例（NAFLD组）及同期体检的健康者80例（健康对照组）。观察NAFLD患者的临床特征,并分别测定2组人群的血脂及血尿酸水平。采用多因素Logistic回归分析血脂、血尿酸与NAFLD的相关性。结果 NAFLD组FPG、HbA_（1c）、TC、TG、LDL—C、UA、ALT、AST及CRP水平,冠心病、高血压、糖尿病发病率均较健康对照组明显升高（P〈0.05）。与单纯NAFLD患者比较,当NAFLD患者合并高脂血脂、高尿酸血症时,肝功能出现显著下降,冠心病及糖尿病发生率明显增加（P均〈0.05）。中老年患者非酒精性肝病以轻中度为主,约占94.17%;空腹血糖（OR=1.762,95%CI 1.024~2.005）、总胆固醇（OR=1.963,95%CI 1.156~2.415）、三酰甘油（OR=1.876,95%CI 1.067~2.377）、低密度脂蛋白（OR=2.122,95%CI 1.243~3.003）、血尿酸（OR=1.343,95%CI 1.013~1.528）、冠心病（OR=2.874,95%CI 1.308~4.972）及糖尿病（OR=2.542,95%CI 1.179~3.672）是非酒精性脂肪肝的危险因素,均呈正相关（P均〈0.05）。结论 老年非酒精性脂肪肝患者主要为轻中度病变,其发生发展与血脂及血尿酸水平密切相关。

Objective To investigate the clinical characteristics of the middle and old aged patients＇ non-alcoholic fatty liver disease （NAFLD） and its correlation with the blood lipid, serum uric acid level. Methods From May 2012 to March 2014, according to the ultrasound results, 120 cases of NAFLD patients （NAFLD group） and 80 cases of healthy physical examinees （healthy control group） were enrolled. Observed the clinical characteristics of patients with NAFLD, serum lipid and uric acid levels were measured in both of the 2 groups. The correlation between blood lipid, blood uric acid and NAFLD was analyzed using the multi factor Logistic regression analysis. Results In the NAFLD group, the FPG, HbA1c, TC, TG, LDL-C, UA, ALT, AST and CRP levels, and coronary heart disease, hypertension, diabetes incidence were significantly increased than the healthy control group （ P 〈 0.05 ）. Compared with patients only with NAFLD, when the NAFLD ptients complicated with hyperlipidemia, hyperuricemia, liver function decreased significantly, the incidence of coronary artery disease and diabetes rate were increased significantly （ P 〈 0.05 ）. Nonalcoholic fatty liver disease in elderly patients mainly were mild to moderate degree, accounting for about 94.17% ; fasting blood glucose （ OR = 1. 762, 95% CI 1. 024 - 2. 005 ）, total cholesterol （ OR = 1. 963, 95% CI 1. 156 - 2. 415）, triacylglycerol （ OR = 1. 876,95% CI 1. 067 - 2. 377）, low density lipoprotein （ OR = 2. 122, 95% CI 1. 243 - 3. 003 ）, blood uric acid （ OR = 1. 343, 95% CI 1. 013 - 1. 528 ）, coronary heart disease （ OR = 2. 874, 95% CI 1. 308 - 4. 972） and diabetes （ OR = 2. 542, 95% CI 1. 179 - 3. 672） were risk factors of non- alcoholic fatty liver, they were positively correlated with the disease （ P 〈 0.05 ）. Conclusion Elderly patients with non-alcoholic fatty liver disease are mainly mild to moderate degree lesions, the genesis and development is closely related to blood lipid and blood uric acid level.