云南省大理州白族老年人代谢综合征与非酒精性脂肪肝的相关性研究

Relationship between metabolic syndrome and non - alcoholic fatty liver disease in the elderly in Dali Baiprefecture area of Yunnan

目的 探讨大理州白族地区老年人代谢综合征（ＭＳ）各组分与非酒精性脂肪性肝病（ＮＡＦＬＤ）的关系，找出ＮＡＦＬＤ的相关危险因素，为防治ＮＡＦＬＤ提供参考。方法 选择门诊或住院患者１０２４例，依据是否存在脂肪肝或ＭＳ分为非ＮＡＦＬＤ组（８０５例）、单纯ＮＡＦＬＤ组（２１９例）及ＮＡＦＬＤ＋ＭＳ组（２１５例），所有患者进行腹部超声检查及血生化检查，分析ＭＳ与ＮＡＦＬＤ之间的关系。结果 （１）ＮＡＦＬＤ与ＭＳ患病率：ＮＡＦＬＤ检出率２１．３９％（２１９／１０２４），男性高于女性（３０．２６％比１１．４１％）（χ２ ＝２６．３５，Ｐ＜０．０１）；ＭＳ检出率为３５．５５％（３６４／１０２４），ＭＳ中ＮＡＦＬＤ检出率高于非ＭＳ组（４０．６６％比１０．７６％）（χ２ ＝３８．１６，Ｐ＜０．００１），ＮＡＦＬＤ检出率随着ＭＳ诊断标准中诊断项目的增多呈上升趋势（χ２＝２２１．１３，Ｐ＜０．００１）。（２）ＮＡＦＬＤ的危险因素：ＮＡＦＬＤ组和ＮＡＦＬＤ＋ＭＳ组中体质量指数（ＢＭＩ）、腰围（ＷＣ）、甘油三酯（ＴＧ）、胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬＣ）、丙氨酸氨基转移酶（ＡＬＴ）、尿酸（ＵＡ）、收缩压（ＳＢＰ）、舒张压（ＤＢＰ）、Ｃ反应蛋白（ＣＲＰ）、空腹血糖（ＦＢＧ）、铁蛋白（ＦＰ）、尿微量白蛋白（ＭＡＵ）、纤维蛋白原（Ｆｇ）均高于非ＮＡＦＬＤ组，高密度脂蛋白胆固醇（ＨＤＬＣ）值低于非ＮＡＦＬＤ组（Ｐ＜０．０１～０．００１），回归分析提示ＷＣ、ＢＭＩ、高ＴＧ、高ＵＡ是ＮＡＦＬＤ危险因素。结论 ＮＡＦＬＤ与ＭＳ关系密切，ＷＣ、ＴＧ、ＢＭＩ、ＳＵＡ是ＮＡＦＬＤ的危险因素。

Objective To investigate the relationship between metabolic syndrome（MS） and non -alcoholic fatty liver disease （ NAFLD）, to find risk factors of NAFLD and provide references for the prevention of NAFLD in patients with MS. Methods 1 024 patients were enrolled, and the patients were divided into the non - NAFLD group, NAFLD group and NAFLD ＋ MS group based on the physical examination outcomes. All the patients received abdominal ultrasound and blood biochemical examination, and the relationship between MS and NAFLD was analyzed. Results （ 1 ） The proportion of NAFLD was 21.39% （ 219/1 024）, which of males was higher than that of females （30.26% vs. 11.41% ,X2 = 26.35,P 〈0.01 ）. The proportion of MS was 35.55% （364/1 024） ,the proportion of NAFLD in the MS group was higher than that in the non - MS group（40.66% vs. 10.76% ,X2 =38.16,P 〈0.001 ）. With the increase of MS examination items,the proportion of NAFDL was increased （X2 = 221.13 ,P 〈 0.001 ）. （2） Compared with the non - NAFLD group, the levels of BMI, WC, TG, TC, LDL - C, ALT, UA, SBP, DBP, CRP, FBG, FP,MAU, Fg in the NAFLD group and NAFLD ＋ MS group were higher, and the level of HDL - C in the NAFLD group and NAFLD ＋ MS group was lower （P 〈 0.01 - 0. 001 ）. The result of logistic regression analysis showed that WC, BMI,high TG, high UA were independent risk facts for the prevalence of NAFLD. Conclusion There is close association between NAFLD and MS, and WC, BMI,TG,SUA are risk factors of NAFLD.