某IT企业员工非酒精性单纯性脂肪肝和非酒精性脂肪性肝炎的初步调查及特征分析

A preliminary investigation and feature analysis of non-alcoholic fatty liver and nonalcoholic steatohepatitis in employees in an IT company

目的调查和分析非酒精性单纯性脂肪肝和非酒精性脂肪性肝炎的发生率及特点,为相关部门做好健康管理、研究制订干预防范措施提供理论依据。方法调取某大型IT企业2016年7月30日-2016年11月3日的体检报告,分析不同年龄段和不同性别NAFL和NASH的发病率,同时分析与超重(或肥胖)、甘油三酯、空腹血糖、血尿酸和血压等指标的相关性。计数资料的比较采用χ~2检验。结果 NAFL和NASH的总发病率分别为4.51%和17.64%,合计22.15%。在NAFLD组(NAFL和NASH)人群中超重(或肥胖)、高血脂和高尿酸的发生率显著高于非NAFLD组(非NAFL和非NASH)人群(91.20%vs 12.68%,χ~2=7571.9,P<0.001;95.06%vs 9.27%,χ~2=9373.8,P<0.001;40.02%vs 10.51%,χ~2=1591.90,P<0.001);男性员工NAFL和NASH的发生率均显著高于女性员工(6.78%vs 1.81%,χ~2=190.35,P<0.001;25.04%vs 5.06%,χ~2=991.90,P<0.001),其超重(或肥胖)、高血脂、高血糖、高尿酸和高血压的发生率也均显著高于女性员工(40.90%vs 12.97%,χ~2=1319.10,P<0.001;36.00%vs16.07%,χ~2=696.22,P<0.001;2.17%vs 0.64%,χ~2=53.82,P<0.01;26.76%vs 1.69,χ~2=1581.10,P<0.001;6.21%vs1.22%,χ~2=170.94,P<0.001)。≥35岁员工NAFL和NASH的发生率均显著高于<35岁员工(8.13%vs 4.47%,χ~2=41.56,P<0.001;21.73%vs 16.76%,χ~2=24.72,P<0.001),高血糖和高血压的发生率也显著高于<35岁员工(2.79%vs 1.43%,χ~2=17.26,P<0.001;6.33%vs 4.03%,χ~2=18.56,P<0.001),但超重(或肥胖)、高血脂和高尿酸的发生率2组比较,差异均无统计学意义(P值均>0.05)。结论 IT企业并未因员工年轻化而呈现NAFLD的发生率明显减少;NAFL和NASH的发生常伴有超重(或肥胖)、高血脂和高尿酸等临床表现,以男性员工为突出;≥35岁员工NAFL和NASH的发生率较年轻员工高,且高血糖、高血压的发生率更高。

Objective To investigate the incidence rates and features of non-alcoholic fatty liver（NAFL） and nonalcoholic steatohepatitis（NASH）,and to provide a theoretical basis for health management and development of intervention and preventive measures in the health management department.Methods Physical examination reports in 2016 were obtained from a large IT company to analyze the incidence rates of NAFL and NASH in different age and sex groups,as well as the correlation with the indices including overweight（or obesity）,triglyceride,fasting blood glucose,blood uric acid,and blood pressure.The chi-square test was used for comparison of rates.Results In all employees,the incidence rates of NAFL and NASH were 4.51% and 17.64%,respectively,and the overall incidence rate of these two diseases was 22.15%.The NAFL-NASH group had significantly higher incidence rates of overweight（or obesity）（91.20% vs 12.68%,χ^2=7571.9,P〈0.001）,hyperlipidemia（95.06% vs 9.27%,χ^2=9373.8,P〈0.001）,and hyperuricemia（40.02% vs 10.51%,χ^2=1591.90,P〈0.001） than the non-NAFL-NASH group.Compared with female employees,male employees had significantly higher incidence rates of NAFL（6.78% vs 1.81%,χ^2=190.35,P〈0.001） and NASH（25.04% vs 5.06%,χ^2991.90,P〈0.001）,as well as significantly higher incidence rates of overweight（or obesity）（40.90% vs 12.97%,χ^2=1319.10,P〈0.001）,hyperlipidemia（36.00% vs 16.07%,χ^2696.22,P〈0.001）,hyperglycemia（2.17% vs 0.64%,χ^2=53.82,P〈0.01）,hyperuricemia（26.76%vs 1.69%,χ^2=1581.10,P〈0.001）,and hypertension（6.21% vs 1.22%,χ^2=170.94,P〈0.001）.Compared with those aged35 years,the employees aged ≥35 years had significantly higher incidence rates of NAFL（8.13% vs 4.47%,χ^2=41.56,P〈0.001） and NASH（21.73% vs 16.76%,χ^224.72,P〈0.001）,as well as significantly higher incidence rates of hyperglycemia（2.79% vs1.43%,χ^2=17.26,P〈0.001） and hypertension（6.33% vs 4.03%,χ^2=18.56,P〈0.001）,while there were no significant differences in the incidence rates of overweight（or obesity）,hyperlipidemia,and high uric acid between these two groups（all P〈0.05）.Conclusion Although IT employees are young,there is no significant reduction in the incidence rate of nonalcoholic fatty liver disease.The development of NAFL and NASH has the clinical features of overweight（or obesity）,hyperlipidemia,and hyperuricemia,which are commonly seen in male patients.Older employees have higher incidence rates of NAFL,NASH,hyperglycemia,and hypertension than younger employees.