中老年体检人群非酒精性脂肪肝患病率调查及与代谢相关因素的相关性

The prevalence and metabolic risk factors of nonalcoholic fatty liver disease among middle-aged and aged people

目的:了解中老年体检人群非酒精性脂肪肝病(NAFLD)的患病率现况,并分析NAFLD与代谢相关因素的相关性。方法:随机选择2014年1月至2015年12月在四川省成都市第三人民医院进行常规健康体检的2 064例体检对象(年龄≥45岁)的体检资料,测定Hb A1c、空腹血糖、血脂等指标,并行肝脏超声检查,计算NAFLD的患病率,分析NAFLD与代谢相关因素的相关关系。结果:2 064例中老年体检对象中,检出NAFLD332例,中老年体检人群NAFLD的总体患病率为16.09%(332/2 064)。男性NAFLD患病率明显高于女性(18.51%vs.12.87%;χ~2=11.913,P=0.001)。NAFLD患病率的年龄分布中,<50岁、50~59岁、60~69岁、≥70岁4个年龄组NAFLD患病率分别为16.26%、15.63%、16.97%、14.72%,各年龄组NAFLD患病率之间差异无统计学意义(χ2=0.900,P=0.826)。50~59岁和≥70岁年龄组男性NAFLD患病率分别高于女性,差异有统计学意义(均P<0.05)。NAFLD患者的BMI、腰围、收缩压、舒张压、Hb A1c、空腹血糖、TC、TG、LDL-C、尿酸水平高于正常人群,而NAFLD患者的HDL-C水平则低于正常者;NAFLD组MS患病率明显高于正常组;差异均有统计学意义(均P<0.05)。Logistic回归分析显示:BMI、高血压、糖尿病、高TG血症是NAFLD的独立危险因素;HDL-C是NAFLD的保护因素。结论:四川省成都地区中老年体检人群NAFLD患病率较高,男性NAFLD患病率高于女性;BMI、高血压、糖尿病、高TG血症是NAFLD的独立危险因素,HDL-C是其保护因素。

Objective To investigate the prevalence of nonalcoholic fatty liver disease in a population of routine check-up, and analyze the correlation between non-alcoholic fatty liver disease and metabolic risk factors. Methods Physical examination data of 2 064 routine check-up （aged 45 or more） in the Third People＇s Hospital of Chengdu from January 2014 to December 2015 were randomly selected. HbAlc, fasting blood glucose, blood lipids and other indicators were measured to calculate the prevalence of NAFLD, and to analyze the correlation between NAFLD and metabolic risk factors. Results Among 2 064 cases underwent physical examination, the overall prevalence of NAFLD was 16.09% （332/2 064）. The male prevalence rate of NAFLD was significantly higher than that in female （18.51% vs. 12.87%; x^2 = 11.913, P = 0.001）. In four age groups （ 〈 50 years old, 50 to 59 years old, 60 to 69 years old, ≥ 70 years old）, the NAFLD prevalence rate was 16.26%, 15.63%, 16.97% and 14.72% respectively. No statistical significance （x^2 = 0.900, P = 0.826） was found in NAFLD prevalence rate difference in all age groups of has. In 50 - 59 years old and ≥70 years old group, the NAFLD prevalence rates in male were higher than that in female, the difference was statistieally significant （both P 〈 0.05）. BMI, waist circumference, systolic blood pressure, diastolic blood pressure （DBP）, HbA1c, fasting blood glucose, TC, TG, LDL-C, uric acid levels in NAFLD patients were higher than the normal population. HDL-C levels in patients with NAFLD is lower than that of the normal, and the difference is statistically significant （both P 〈 0.05）. Logistic regression analysis showed that BMI, hypertension, diabetes, and high TG were the independent risk factors of NAFLD; HDL-C and NAFLD were the protective factors. Conclusions In the Chengdu area of Sichuan Province, the prevalence rate of NAFLD was high, the incidence rate of NAFLD in male was higher than that in female. BMI, hypertension, diabetes mellitus and high TG were the independent risk factors of NAFLD, and HDL-C was the protective factor.