腰围身高比值与非酒精性脂肪肝的相关性分析

Relationship between the waist-to-height ratio and the non-alcoholic fatty liver disease

目的 分析腰围身高比值（WHtR）与非酒精性脂肪肝（NAFLD）的相关性.方法 本研究选取2011-2012年度于我院参加健康体检的开滦集团员工7 896例作为研究对象,进行统一问卷调查,同时行血液生化及肝脏超声检查.根据国外研究的WHtR切点将所有观察对象分为两组：非腹型肥胖组479例（WHtR〈0.5）和腹型肥胖组3 185例（WHtR≥0.5）,比较两组间NAFLD 的检出率,同时依据WHtR四分位数将观察对象分为4个亚组：即WHtR〈0.47组、0.47≤WHtR〈0.51组、0.51≤WHtR〈0.55组和WHtR≥0.55组.比较4组间NAFLD的检出率.应用多因素Logistic回归分析找出影响NAFLD的危险因素.结果 （1）腹型肥胖组NAFLD的检出率（62.7%）高于非腹型肥胖组（21.5%）,差异有统计学意义（P均〈0.01）.随着WHtR的增加,NAFLD的检出率逐渐升高,WHtR〈0.47组、0.47≤WHtR〈0.51组、0.51≤WHtR〈0.55组和WHtR≥0.55组NAFLD的检出率逐渐升高,分别为12.6 %、38.1%、57.5%和72.5%.按性别分层后,男性4组NAFLD检出率分别为15.1%、40.6%、59.6%和75.0%,女性分别为7.8%、31.5%、48.3%和63.8%.相同WHtR分组间男性NAFLD的检出率高于女性,差异均有统计学意义（P均〈0.01）.（2）影响NAFLD的多因素Logistic回归分析显示,校正年龄、性别等因素后与WHtR〈0.47组比较,0.47≤WHtR〈0.51组、0.51≤WHtR〈0.55组和WHtR≥0.55组均增加NAFLD的患病风险,OR值分别为3.19、5.93和9.81.在不同性别人群中,校正上述因素后与WHtR〈0.47组比较,0.47≤WHtR〈0.51组、0.51≤WHtR〈0.55组和WHtR≥0.55组均增加NAFLD的患病风险,男性OR值分别为3.12、6.02和10.45,女性OR值分别为3.32、5.37和7.57.结论 随着WHtR水平增加,NAFLD的患病风险加大.

Objective To analysis the relationship between of waist-to-height ratio（WHtR） and the non-alcoholic fatty liver disease（NAFLD）.Methods A total of 7 896 were selected as observed subjects from the Kailuan Group in 2011-2012 health physical examination.A questionnaire survey,blood biochemical and abdominal ultrasound examination were finished by trained medical staff.According to previous study recommended cut points the observed subjects was divided into two groups：abdominnal obesity group（WHtR≥0.5,n=3 185） and non-abdominnal obesity group（WHtR〈0.5,n=479）.According to the WHtR and its quartile,the observed subjects was divided into four groups（first（WHtR〈0.47）,second（0.47≤WHtR〈0.51）,third（0.51≤WHtR〈0.55） and forth（WHtR≥0.55） quartile groups）.NAFLD detection rate of the four groups were Compared.Multiple Logistic regression analysis was used to analyze the influencing factors of the NAFLD.Results （1）The detection rate of NAFLD in abdominnal obesity group was higher than that in non-obesity group（62.7% vs.21.5%,P〈0.01）.Along with increasing WHtR level in the 4 quartile groups,the incidence of NAFLD was progressively increased,being 12.6 %,38.1%,57.5% and 72.5% respectively in the total population.After stratified by gender,15.1%,40.6%,59.6% and 75.0% in male,7.8%,31.5%,48.3% and 63.8% in female.In the same WHtR group,the NAFLD detection rate of male was higher than female,the differences were statistically significant（P〈0.01）.（2）Multiple logistic regression analysis showed that compared with the first quartile group,the second,third and forth quartile groups had increased risk of NAFLD after adjusting age,gender and other risk factors,the OR value being 3.19,5.93 and 9.81 in the total population.After adjusting above factors,the OR value being 3.12,6.02 and 10.45 in male,3.32,5.37 and 7.57 in female,respectively.Conclusion The incidence of NAFLD is increased along with the increasing the WHtR.