苯作业人群非酒精性脂肪性肝病与颈动脉粥样硬化的相关性

Correlation of nonalcoholic fatty liver disease and carotid atherosclerosis in benzene-exposed workers

目的研究苯作业人群非酒精性脂肪性肝病(NAFLD)与颈动脉粥样硬化之间的相关性。方法选取苯作业工人1 803例和非苯作业工人1 206例,对两组人群肝、颈动脉超声及丙氨酸转氨酶(ALT)检查结果进行分析。根据肝脏超声检查结果,将苯作业人群分为苯作业正常肝人群和苯作业NAFLD人群;苯作业NAFLD人群进一步分为NAFLD轻-中度组和重度组;统计上述各组人群颈动脉粥样硬化及ALT异常情况。对NAFLD轻-中度组和重度组人群按照不同性别及年龄段分组,分别统计两组人群不同性别、不同年龄段颈动脉粥样硬化的患病率。结果苯作业人群NAFLD、颈动脉粥样硬化、ALT异常检出率均高于非苯作业人群,苯作业NAFLD人群颈动脉粥样硬化、ALT异常检出率显著高于苯作业正常肝人群,苯作业NAFLD重度组颈动脉粥样硬化、ALT异常检出率均高于轻-中度组。对年龄及性别分组后显示,两组在男性及≥45岁年龄段中,颈动脉粥样硬化检出率差异有统计学意义。结论苯作业人群中,NAFLD及颈动脉粥样硬化检出率较高,且颈动脉粥样硬化检出率随着脂肪肝严重程度加重而升高,男性和高龄也是颈动脉粥样硬化的危险因素。

Objective To investigate the correlation of nonalcoholic fatty liver disease（NAFLD）and carotid atherosclerosis in benzene-exposed workers. Methods 1803 benzene-exposed workers and 1206 non- benzene-exposed workers received the ultrasound examination for liver and carotid artery, as well as alanine aminotransferase（ALT） examination. The benzene-exposed workers were divided into two parts： NAFLD workers and normal liver workers according to liver ultrasound, and then NAFLD workers were divided into two groups： mild to moderate NAFLD group and severe NAFLD group, the level of ALT and carotid atherosclerosis were detected and analyzed. The prevalence of carotid atherosclerosis was analyzed in different genders and ages between mild to moderate NAFLD group and severe NAFLD group. Results The detection rates of NAFLD, carotid atherosclerosis and the abnormal rate of ALT in benzene-exposed workers were higher than those in non benzene-exposed workers. The detection rates of carotid atherosclerosis and the abnormal rate of ALT in NAFLD workers were significantly higher than those in normal liver workers. The detection rate of carotid atherosclerosis and the abnormal rate of ALT in mild to moderate NAFLD group were higher than those in severe NAFLD group, and then the prevalence of carotid atherosclerosis was analyzed in different genders and ages between two groups respectively. The result showed that both in the male group and the group older than 45 years old, the detection rate of carotid atherosclerosis in severe NAFLD group was higher than that in mild to moderate NAFLD group, which showed significant difference. Conclusions The detection rate of NAFLD, carotid atherosclerosis in benzene-exposed workers were higher than those in non- benzene-exposed workers. With the development of fatty liver degree, the detection rate of carotid atherosclerosis increased significantly. Male and aging were also risk factors of carotid atherosclerosis.