中性粒细胞计数与非酒精性脂肪肝关联性的前瞻性队列研究

Association between neutrophil count and nonalcoholic fatty liver disease:a prospective cohort study

目的探讨中性粒细胞计数与非酒精性脂肪肝(NAFLD)的关联性。方法基于大规模健康管理队列,针对队列基线中无NAFLD的15 463例健康体检对象随访,平均随访时间2.54年,随访结局为发生NAFLD;将基线中性粒细胞计数根据四分位数由低到高划分为4个组段(Q1、Q2、Q3、Q4);采用多元Cox回归计算中性粒细胞计数与NAFLD关联性的相对危险度(HR)。结果随访期间3 846人被诊断为NAFLD。Cox结果显示,以Q1为参照,在调整年龄、性别后,中性粒细胞计数的Q2、Q3、Q4三个组段的HR(95%CI)分别为1.265(1.057,1.514)、1.446(1.214,1.724)、1.605(1.350,1.907),上述基础上再调整谷丙转氨酶和γ-谷酰胺转酞酶后,Q2、Q3、Q4三个组段的HR(95%CI)分别为1.264(1.056,1.512)、1.434(1.202,1.710)、1.582(1.330,1.882),进一步调整血脂四项、空腹血糖、体质量指数(BMI)和高血压后,HR(95%CI)分别为1.181(0.986,1.415)、1.189(0.995,1.420)、1.226(1.026,1.464)。结论中性粒细胞计数是NAFLD发病的独立危险因素。

Objective To explore the longitudinal association between neutrophil count and nonalcoholic fatty liver dis- ease （NAFLD）. Methods The cohort consisted of 15 463 non-NAFLD individuals at baseline who were followed for the incident of NAFLD. Cox model was applied to calculate the hazard ratio （HR） and its 95 % confidence intervals （ 95 % CI） of quantiles （ Q1, Q2, Q3 and Q4） of neutrophil count predicting NAFLD. Results During the follow-up, 3 846 new cases of NAFLD occurred. With Q1 as reference group, after adjusting for age and gender, the HRs （95% CI） of Q2, Q3, and Q4 were 1.265 （1.057,1.514）, 1.446 （1.214,1.724） and 1.605 （1. 350,1.907）, respectively. On the basis of previous model, alanine aminotransferase and gamma glutamyltransferase were added into the model, and the HRs （95% CI） of Q2, Q3, and Q4 were 1. 264 （ 1. 056,1. 512）, 1. 434 （ 1. 202,1. 710） and 1. 582 （ 1. 330,1. 882）, respectively. After adding BMI, systolic pressure, diastolic pressure, fasting glucose and blood lipids into the model, the HRs （95% CI） were 1. 181 （0.986,1.415）, 1. 189（0.995,1.420） and 1.226（1.026,1.464）, respectively. Conclusion Neutrophil count is an independent risk factor for the incidence of NAFLD.