中年男性脂肪肝的患病率和危险因素研究

Prevalence characteristics of fatty liver and it＇s risk factors analysis in middle-aged men

目的 探讨中年男性脂肪肝的患病率及其危险因素。 方法 选取2014年1月至2015年12月该院健康体检中心的中年男性2 760例，年龄30~60岁，平均年龄（45.72±8.8）岁，经超声明确诊断为脂肪肝患者1 074例。分析不同特征中年男性脂肪肝的患病情况，比较中年男性脂肪肝与非脂肪肝组血液生化指标的差异，应用多因素logistic分析中年男性脂肪肝的危险因素。 结果 中年男性体检人群中B超共检出脂肪肝1 074例，患病率为38.9%，其中40~50岁年龄层男性脂肪肝患病率最高达42.6%。血压升高组脂肪肝的患病率较血压正常组升高（53.9% vs .32.3%， P 〈0.001）;超重和肥胖人群脂肪肝患病率显著高于体重正常组（49.5% vs .81% vs .15.1%， P 〈0.001），空腹血糖升高组脂肪肝患病率显著高于空腹血糖正常组（67.9% vs. 36.5%， P 〈0.001）；高甘油三酯血症、高胆固醇血症、混合型高脂血症、低HDL-胆固醇血症人群脂肪肝患病率显著高于正常组（55.9% vs .30.8% vs .62.6% vs .39.8% vs .19.7%， P 〈0.001）。脂肪肝组α-L-岩藻糖苷酶（AFU）、总蛋白、结合胆红素、糖化血红蛋白、谷草转氨酶、LDL-胆固醇、r-谷氨酰酶、谷丙转氨酶、尿素、MCHC、血红蛋白、血小板计数、红细胞计数、嗜中性粒细胞%、血小板压积、红细胞压积平均水平均高于非脂肪肝组（ P 均小于 0.05 ）。HDL-胆固醇水平、白球比例均低于非脂肪肝组（ P 均〈0.05）。多因素logistic回归分析提示年龄增长、肥胖、血糖升高、血压升高、高甘油三酯血症、低HDL-胆固醇血症升高是中年男性发生脂肪肝的危险因素（其OR值分别为1.531、12.067、2.230、2.284、1.436、2.987、1.724、 P 均〈0.05）。 结论 40~50岁男性在中年男性中脂肪肝发病率最高，肥胖、糖尿病、高血压、高甘油三酯血症、低HDL-胆固醇血症与脂肪肝发生密切相关。

Objective： Explore Prevalence rate and risk factors of fatty liver in middle-aged men. Methods： In 2 760 middle-aged men healthy subjects,aged 30-60 years old,with an average age of 45.72±8.8 years in our hospital physical examination center,there were 1704 fatty liver cases were diagnoses by ultrasonic test during January 2014 to 2015 December.The prevalence of different characteristics in middle-aged men with fatty liver was analyzed,the Difference of blood biochemical index between fatty liver and non fatty liver group was compared,and risk factors of fatty liver was explored by multiple factor regression analysis. Results： The total prevalence rate of fatty liver in middle-aged men was38.9%,which in male age 40-50 is up to 42.6%.The prevalence rate of fatty liver in the high blood pressure group was higher than that in the normal blood pressure group （53.9% vs. 32.3%, P 〈0.001）.The prevalence of fatty liver in overweight and obese people was significantly higher than that in normal weight group （49.5% vs. 81% vs. 15.1%, P 〈0.001）.The prevalence of fatty liver in the fasting hyperglycemia group was significantly higher than that in the normal fasting blood glucose group （67.9% vs. 36.5%, P 〈0.001）.The prevalence of fatty liver in hypertriglyceridemia,hypercholesterolemia,mixed hyperlipidemia and low HDL- cholesterolemia was significantly higher than that in normal group （55.9% vs. 30.8% vs. 62.6% VS39.8% vs. 19.7%, P 〈0.001）.Average levels of alpha -L- fucosidase （AFU）,total protein,glycosylated hemoglobin,total bilirubin,aspartate aminotransferase,LDL- cholesterol,r- glutamyl,alanine aminotransferase,urea,MCHC,hemoglobin,platelet count,erythrocyte count,neutrophils%,plateletcrit and hematocrit in fatty liver group were higher than those in non fatty liver group （ P 〈0.05）.The level of HDL- cholesterol and the proportion of white ball in fatty liver group were lower than those in the non fatty liver group （ P 〈0.05）.Logistic regression analysis showed that age,obesity,hyperglycemia,hypertension,hypertriglyceridemia,low HDL- cholesterol levels were risk factors in middle-aged male the occurrence of fatty liver （the OR values were 1.531,12.067,2.230,2.284,1.436,2.987,1.724, P 〈0.05）. Conclusion： Men aged 40 to 50 have the highest prevalence rate of fatty liver disease in middle-aged men and obesity,diabetes,hypertension,hypertriglyceridemia and low HDL- cholesterol are closely related to fatty liver.