广州市成年人非酒精性脂肪肝的相关因素

Risk factors of nonalcoholic fatty liver disease in an adult population in Guangzhou

目的探讨广州市成年人非酒精性脂肪肝(NAFLD)的相关因素。方法采用横断面调查的方法,通过问卷调查、体格检查、实验室检测和B超检查等形式对468例在中山大学附属第三医院进行体检的成年人进行资料收集与整理,其中NAFLD患者213例,其余255例纳入对照组。使用Logistic回归分析代谢相关因子与NAFLD的关系。结果本研究中,NAFLD患者占45.51%(213/468),男性患者高于女性。NAFLD组比对照组有更高的年龄、体质指数(BMI)、腰围(WC)、血压、空腹血糖(FPG)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、三酰甘油(TG)、尿酸(UA)及血红蛋白(Hb),更低的高密度脂蛋白胆固醇(HDL-C),差异有统计学意义(P<0.05)。在控制年龄、性别、吸烟、喝酒和体力活动后,WC、SBP、FPG、ALT、AST、TG、UA、Hb与NAFLD呈显著正相关(OR>1.00,P<0.01),而HDL-C与NAFLD呈显著负相关(OR=0.499,P<0.001)。其中,ALT的变化对NAFLD患病影响最大,其次为WC,每升高一个标准差(s)对应的OR(95%CI)分别为12.593(6.520~24.323),11.560(7.190~18.587)。结论代谢相关因子与NAFLD的关系密切,其中ALT和WC变化对NAFLD患病影响最大。

Objective To analyze the role of related factors on nonalcoholic fatty liver disease （NAFLD） in an adult population in Guangzhou. Methods This cross-sectional study consecutively recruited 468 participants （including 213 NAFLD patients and 255 controls） from Center of Physical Examination, the Third Affiliated Hospital of Sun Yat-sen University. A structured questionnaires survey was conducted to collect general information. Anthropometfic and laboratory parameters were also measured. An abdominal ultrasound was applied to detect steatosis. A logistic regression was performed to assess the associations between metabolic risk factors and NAFLD. Results The ratio of NAFLD patients was 45.51% （213/468）, and male had a higher prevalence of NAFLD than that of female. Compared to the control group （n=255） , the NAFLD patients were older and had higher BMI, WC, blood pressure, FPG, ALT, AST, TG, UA and Hb, and lower level of HDL-C. After adjusting for age, gender, and lifestyle factors, higher WC, SBP, FPG, ALT, AST, TG, UA and Hb were associated with an increased risk of NAFLD （OR〉1.00, P〈0.01）. While HDL-C was negatively associated with NAFLD （OR=0.499, P〈0.001 ）. ALT and WC were the most major risk factors for NAFLD, the OR （95% CI） for ALT was 12.593 （6.520-24.323） , and 11.560 （7.190-18.587） for WC. Conclusion Metabolic factors are closely associated with NAFLD ; ALT and WC are the leading risk factors for NAFLD.