西安市某企业员工非酒精性脂肪性肝病的调查分析

Current status of nonalcoholic fatty liver disease and related risk factors: an analysis of an enterprise in Xi'an

目的对西安市某企业单位非酒精性脂肪性肝病（NAFLD）现况进行调查分析,为NAFLD的进一步研究提供科学依据。方法对2014年6月-7月在西安医学院第一附属医院体检的415例某企业单位员工进行体格检查、腹部超声检查、血清学检查及问卷调查。计量资料组间比较采用t检验,相关性分析采用Pearson相关分析。结果 415例员工中NAFLD 86例（20.7%）,其中轻度脂肪肝70例（16.9%）、中度脂肪肝16例（3.8%）;50~58岁人群患病率最高（30.8%,16/52）;86名NAFLD员工中肥胖症57例（66.3%）、腹型肥胖76例（88.4%）;中度脂肪肝员工的ALT水平、AST水平、腹围和BMI均高于轻度脂肪肝员工,差异均有统计学意义（t值分别为-4.14、-3.512、-4.405、-5.051,P值均〈0.05）;NAFLD员工的BMI、腹围均与AST水平（r值分别为0.283、0.271）和ALT水平（r值分别为0.325、0.316）有相关性（P值均〈0.05）;该企业单位员工总体存在不良饮食习惯和久坐、缺乏体育锻炼等不良生活习惯。结论该企业单位中NAFLD的患病率处于国内较高水平,NAFLD的BMI和腹围对预测肝内脂肪沉积程度具有一定的临床意义且均与AST、ALT水平有相关性。

Objective To investigate the current status of nonalcoholic fatty liver disease（ NAFLD） in an enterprise in Xi’an,China,and to provide a scientific basis for further studies on NAFLD in Shanxi. Methods A total of 415 employees who underwent health examination in The First Affiliated Hospital of Xi’an Medical University from June to July,2014 were enrolled. All the patients underwent physical examination,abdominal ultrasound,and serological examination,and completed related questionnaires. The t- test was applied for comparison of continuous data,and the Pearson correlation analysis was applied for correlation analysis. Results Of all the 415 patients,86（ 20. 7%）had NAFLD,consisting of 70 patients（ 16. 9%） with mild NAFLD and 16 patients（ 3. 8%） with moderate NAFLD. The population with an age of 50- 58 years had the highest prevalence rate（ 30. 8%,16 /52）. Of all the 86 patients with NAFLD,57（ 66. 3%） had obesity,and76（ 88. 4%） had abdominal obesity. The employees with moderate NAFLD had a significantly higher alanine aminotransferase（ ALT） level,a significantly higher aspartate aminotransferase（ AST） level,a significantly larger abdominal circumference,and a significantly higher body mass index（ BMI） than those with mild NAFLD（ t =- 4. 140,- 3. 512,- 4. 405,and- 5. 051,respectively,all P 〈 0. 05）. In the employees with NAFLD,BMI and abdominal circumference were correlated with AST level（ r = 0. 283 and 0. 271,both P 〈 0. 05） and ALT level（ r = 0. 325 and 0. 316,both P 〈 0. 05）. Most employees in this enterprise had a bad eating habit,a sedentary lifestyle,and a lack of physical exercise. Conclusion This enterprise has a high prevalence rate of NAFLD. BMI and abdominal circumference of patients with NAFLD have certain clinical values in predicting the degree of fat deposition in the liver,and are correlated with AST and ALT levels.