成年体检人群中白细胞计数与非酒精性脂肪肝的关联

Relationship between white blood cell count and nonalcoholic fatty liver disease in an adultpopulation

目的探讨成年体检人群中白细胞计数与非酒精性脂肪肝（包括单纯性脂肪肝和非酒精性脂肪性肝炎）的关联。方法对象为2010至2014年天津医科大学总医院健康管理中心的体检人群。单纯性脂肪肝和非酒精性脂肪性肝炎根据肝脏超声检查和血清丙氨酸转氨酶浓度进行诊断。最终纳入37507人，其中单纯性脂肪肝8644例、非酒精性脂肪性肝炎2557例。利用Logistic回归模型评估白细胞计数四分位水平与非酒精性脂肪肝患病情况的关系。结果调整混杂因素后，随着白细胞计数水平的增高，单纯性脂肪肝患病的比值比（95％CI）分别为1．00（参考组），1．37（1．24，1．50），1．70（1．55，1．86）和2．09（1．90，2．29）（趋势P〈O．0001）；非酒精性脂肪性肝炎患病比值比（95％CI）分别为1．00（参考组），1．39（1．16，1．66），1．69（1．43，1．99）和2．13（1．81，2．50）（趋势P〈O．0001）。结论成年人群中白细胞计数与单纯性脂肪肝和非酒精性脂肪性肝炎存在相关关系，需进一步研究探讨白细胞计数在单纯性脂肪肝和非酒精性脂肪性肝炎发病过程中的预测价值。

Objective To investigate the relationship between white blood cell count （WBC） and the prevalence of simple fatty liver disease （SFL） and nonalcoholic steatohepatitis （NASH）. Methods We designed a large scale cross-sectional study in an adult population. Participants were selected from Tianjin Medical University＇s General Hospital-Health Management Centre. The diagnoses of simple fatty liver disease and nonalcoholic steatohepatitis were based on liver uhrasonography and serum alanine aminotransferase concentration. A total of 37 507 subjects （8 644 SFL and 2 557 NASH） were included in this study. Multiple logistic regression analysis was used to assess whether the quartiles of WBC were associated with the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Results After adjusting for potential confounders, the odds ratios （95% confidence interval） of simple fatty liver disease and nonalcoholic steatohepatitis for increasing quartiles of WBC were： simple fatty liver disease, 1.00 （reference）, 1.37 （1.24, 1.50）, 1.70 （1.55, 1.86） and 2.09 （1.90, 2.29） （P for trend〈0.000 1）; nonalcoholic steatohepatitis, 1.00 （reference）, 1.39 （1.16, 1.66）, 1.69 （1.43, 1.99） and 2.13 （1.81, 2.50） （P for trend〈0.000 1）. Conclusions This study proves the correlation between WBC and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Further study is needed to clarify whether WBC has a predictive value for the occurrence of nonalcoholic fatty liver disease.