非酒精性脂肪性肝病患者体重指数与代谢异常及肝脏炎症程度的相关性分析

The correlation of metabolic disorder and the degree of liver inflammation with body mass index in patients of nonalcoholic fatty liver disease

目的探讨非酒精性脂肪性肝病（NAFLD）患者体重指数（BMI）与代谢异常的相关性，比较分析不同BMI患者的肝脏炎症程度。方法将579例NAFLD患者按BNI值分为正常体重组（55例）、超重组（345例）及肥胖组（179例），比较3组患者的代谢及肝脏炎症指标。结果3组患者血压[收缩压：（120．57±15．34）mmHg、（123．78±12．02）峨、（127．69±13．57）mmHg，P=0．000；舒张压：（73．71±10．07）mmHg、（77．85±9．65）mmHg、（80．25±8．83）mmHg，P=0．000]、ALT[（23．31±12．35）U／L、（27．77±13．79）U／L、（32．33±20．03）U／L，尸=0．000}、AST[（20．16±7．59）U／L、（21．38±7．27）U／L、（23．41±9．84）U／L，P=0．007]、高密度脂蛋白胆固醇（HDL—C）水平[（1．10±0．25）mmol／L、（1．00±0．20）mmol／L、（0．99±0．19）mmol／L，P=0．003]、尿酸（UA）水平[（364．01±91．43）μmol／L、（393．34±87．29）μmol／L、（403．47±94．23）μmol／L，P=0．018]、NAFLD纤维化评分（NFS）[（-1．91±1．31）、（-1．45±1．17）、（-1．02±1．20），P=0．000]、糖代谢异常比例（36．4％、44．1％、50．3％，P=0．003）以及高血压比例（38．2％、48．4％、64．2％，P=0．000）比较，差异均有统计学意义。结论随着BMI的升高，NAFLD患者代谢异常的比例、肝脏炎症程度及纤维化程度升高。肥胖与NAFLD及代谢紊乱密切相关。

Objective To explore the correlation of body mass index（BMI） and metabolic disorder in patients with nonalcoholic fatty liver disease （NAFLD） and compare the degree of liver inflammation in the patients with different BMI. Methods According to BMI,579 NAFLD patients were divided into normal weight group （55 patients）, overweight group （345 patients） and obesity group （ 179 patients ）. The metabolic components and degree of liver inflammation were compared between the three groups. Results The levels of blood pressure [ systolic blood pressure （ 120. 57 ± 15.34 ） mmHg vs （ 123. 78 ± 12. 02 ） mmHg vs （127.09 ±13. 57）mmHg,P =0.000）;diastolic blood pressure （ 73.71±10.07 ） mmHg vs （ 77.85 ± 9.65 ） mmHg vs （80.25 ±8.83） mmHg, P =0. 000） ,ALT[（23.31 ± 12.35） U/L vs （27. 77 ± 13.79） U/L vs （32.33±20.03）U/L,P =0.000] ,AST[ （20. 16 ±7.59）U/L vs （21.38 ±7.27）U/L vs （23.41 ±9.84）U/L, P =0. 007] ,high density lipoprotein[ （1.10±0. 25） mmol/L vs （ 1.130±0. 20）mmol/L vs （0. 99 ±0. 19） mmol/L, P=0.0003],uric acid[（364.01 ±91.43） μmol/L vs （393.34±87. 29）μmol/L vs （403.47 ±94. 23） μmol/L, P =0.018] ,NAFLD fibrosis scores（NFS） [ （ -1.91±1.31） vs （ -1.45 ±1.17） vs （ - 1.02 ±1.20）,P =0.0130] and the proportion of abnormal glucose metabolism（ 36.4% vs 44. 1% vs 50.3% ,P = 0. 003 ）, hypertension （38.2% vs 48.4 vs 64.2%, P = 0. 000） among the three groups were statistically different （ P 〈 0. 05 ）. Conclusion With the increase of BMI levels, the proportion of metabolism disorder of NAFLD patients is increased as well as the degree of liver inflammation and fibrosis also increased. There is close relationship between obesity and metabolic disorders with NAFLD and the degree of inflammation and fibrosis of NAFLD are higher in obese patients.