C-反应蛋白对新发非酒精性脂肪肝的预测价值

Predictive value of C-reactive protein in emerging non-alcoholic fatty liver disease

目的探讨C-反应蛋白（CRP）对新发非酒精性脂肪肝（NAFLD）的预测价值。方法采用前瞻性队列研究，以参加2006年7月至2007年10月健康体检的101510名某集团公司职工为研究对象，排除饮酒者、既往脂肪肝、心肌梗死、脑卒中、恶性肿瘤以及资料不全者，最终25843例纳入队列，将研究对象按基线CRP浓度分为三组，即CRP〈1mg／L组、CRP1～3mg／L组和CRP〉3mg／L组，比较各组新发NAFLD的检出率并采用多因素logistic回归模型分析各组NAFLD的发病风险。结果随着CRP浓度的增加，年龄、收缩压、舒张压、腰围、体质量指数、空腹血糖、总胆固醇、血尿酸水平、男性所占比例呈递增趋势护〈0．01）。CRP〈1mg／L组、CRP1～3mg／L组和CRP〉3mg／L组新发NAFLD检出率分别为24．6％、29．6％和30．6％（x2=92．10，P〈0．01）。logistic回归分析结果显示，在校正年龄、性别、腰围等混杂因素后，CRP1～3mg／L组和CRP〉3mg／L组发生NAFLD风险分别为CRP〈1mg／L组的1．09（95％可信区间1．01～1．17）和1．24（95％可信区间1．13～1．35）倍。结论CRP是NAFLD发病的独立预测因子。

Objective To investigate the predictive value of C-reactive protein （CRP） in emerging non- alcoholic fatty liver disease （NAFLD）. Methods A prospective cohort study was performed. A total of 101510 employees of Kailuan Group Company who underwent physical examination from July 2006 to October 2007 were enrolled as study subjects. The employees with a history of drinking, fatty liver disease, myocardial infarction, stroke, and malignant tumors and incomplete data were excluded. Finally 25843 employees were enrolled in the cohort study. According to the baseline ClIP level, these employees were divided into CRP 〈 1 mg/L group, CRP 1-3 mg/L group, and CRP 〉 3 mg/L group. The detection rate of emerging NAFLD was compared between groups, and the multivariate logistic regression model was used to analyze the risk of NAFLD in each group. Results With the increasing CRP level, age, systolic pressure, diastolic pressure, waist circumference, body mass index, fasting blood glucose, total cholesterol, serum uric acid, and the proportion of male patients tended to increase （P 〈 0.01）. The detection rate of emerging NAFLD was 24.6% in the CRP 〈 1 mg/L group, 29.6% in the CRP 1-3 mg/L group, and 30.6% in the CRP 〉 3 mg/L group （X2 = 92.10, P 〈 0.01 ）. The results of the logistic regression analysis showed that after the confounding factors such as age, sex, and waist circumference were corrected, the risk of NAFLD in the CRP 1-3 mg/L group and CRP 〉 3 mg/L group was 1.09 （95% CI 1.01-1.17） and 1.24 （95% CI 1.13-1.35） times that in the CRP 〈 1 mg/L group. Conclusion CRP is the independent risk factor for the development of NAFLD