唐山市体检人群脂肪肝患病率调查分析

An investigation of the prevalence rate of fatty liver disease among people undergoing physical examination in Tangshan,China

目的探究唐山市体检人群脂肪肝患病率情况,以期为脂肪肝的预防和调治提供合理依据。方法采集2014年3月-2016年2月唐山市12 808例体检人群资料,其中脂肪肝有3540例。统计年龄、性别、BMI、空腹血糖(FBG)、TC、TG、LDL-C以及肝脏超声检查结果。计数资料组间比较采用χ2检验;计量资料组间比较采用t检验。结果 7151例男性体检者中脂肪肝2750例(38.46%),5657例女性体检者中脂肪肝790例(13.96%),男性与女性患病率比较差异有统计学意义(χ2=947.25,P<0.01)。不同年龄段(18~29岁、30~39岁、40~49岁、≥50岁)男女间脂肪肝检出率比较差异均有统计学意义(χ2值分别为337.58、474.06、449.38、12.86,P值均<0.01)。男性、女性在不同BMI[肥胖(BMI≥28)、超重(24≤BMI<28)、正常(BMI<24))]间脂肪肝的检出率比较差异有统计学意义(χ2值分别为1104.01、500.23,P值均<0.01)。分别对肥胖(BMI≥28)、超重(24≤BMI<28)、正常(BMI<24)体检者中男性与女性脂肪肝检出率进行比较,差异均有统计学意义(χ2分别为71.24、87.97、323.84,P值均<0.01)。男性、女性体检者中肥胖及超重人群脂肪肝检出率均显著高于正常人群(P值均<0.01)。脂肪肝组与非脂肪肝组FPG、TC、TG、LDL-C比较,差异均有统计学意义(t值分别为17.482、13.698、22.133、27.334,P值均<0.001)。男性体检者中,脂肪肝与非脂肪肝体检者间FPG、TC、TG、LDL-C水平比较,差异均有统计学意义(t值分别为11.288、8.652、11.671、20.118,P值均<0.01);女性体检者中,脂肪肝与非脂肪肝体检者间FPG、TC、TG、LDL-C水平比较,差异均有统计学意义(t值分别为16.816、5.532、15.154、18.507,P值均<0.01)。结论唐山市成人体检人群脂肪肝患病率为男性明显高于女性。导致脂肪肝的主要因素可能是超重或肥胖、高脂血症、糖代谢异常。

Objective To investigate the prevalence rate of fatty liver disease among people undergoing physical examination in Tangshan,China,and to provide a reasonable basis for the prevention and treatment of fatty liver disease. Methods The clinical data of 12 808 individuals who underwent physical examination in Tangshan from March 2014 to February 2016 were collected,and among these individuals,3540 had fatty liver disease. The data including age,sex,body mass index（ BMI）,fasting plasma glucose（ FPG）,total cholesterol（ TC）,triglyceride（ TG）,low-density lipoprotein cholesterol（ LDL-C）,and liver ultrasound findings were analyzed. The t-test was used for comparison of continuous data between groups and the chi-square test was used for comparison of categorical data between groups. Results Of all 7151 male individuals who underwent physical examination,2750（ 38. 46%） had fatty liver disease,and of all 5657 female individuals,790（ 13. 96%） had fatty liver disease; there was a significant difference in the prevalence rate of fatty liver disease between male and female individuals（ χ^2= 947. 25,P〈0.01）. There was a significant difference in the detection rate of fatty liver disease between male and female individuals in each age group of 18-29,30-39,40-49,and ≥50 years（ χ^2= 337. 58,474. 06,449. 38,and 12. 86,all P〈0.01）. There was a significant difference in the detection rate of fatty liver disease between male or female individuals with different BMIs[obese（ BMI ≥28）,overweight（ 24≤BMI 〈28）,and normal（ BMI〈 24） ]（ χ^2= 1104. 01 and 500. 23,both P〈0.01）. In the three groups of obese（ BMI ≥28）,overweight（ 24≤BMI 〈28）,and normal（ BMI 〈24） individuals who underwent physical examination,there was a significant difference in the detection rate of fatty liver disease between male and female individuals in each group（ χ^2= 71. 24,87.97,and 323. 84,all P〈0.01）. Male and female individuals with obesity（ BMI ≥28） and overweight（ 24≤BMI 〈28） had a significantly higher detection rate of fatty liver disease than those with normal BMI（ both P〈0.01）. There were significant differences in FPG,TC,TG,and LDL-C between the fatty liver group and the non-fatty liver group（ t = 17. 482,13. 698,22. 133,and 27. 334,all P〈 0. 001）. In male individuals who underwent physical examination,there were significant differences in FPG,TC,TG,and LDL-C between the individuals with and without fatty liver disease（ t = 11. 288,8. 652,11. 671,and 20. 118,all P〈0.01）; in female individuals,there were also significant differences in FPG,TC,TG,and LDL-C between the individuals with and without fatty liver disease（ t = 16. 816,5. 532,15. 154,and 18. 507,all P〈0.01）. Conclusion Among the adults undergoing physical examination in Tangshan,male adults have a significantly higher prevalence rate of fatty liver disease than female adults. Overweight or obesity,hyperlipidemia,and abnormal glucose metabolism are major causes of fatty liver disease.