体检人群非酒精性脂肪性肝病与高尿酸血症及脂代谢紊乱的关系

Relationship among nonalcoholic fatty liver disease,hyperuricemia and dyslipidaemia in health checkup polulation

目的分析探讨非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)与高尿酸血症(hyperuricemia,HUA)及脂代谢紊乱的关系。方法选取参加健康体检且符合纳入及排除标准者8 330例,分析其人口学特征及NAFLD检出情况,比较NAFLD组与非NAFLD组HUA及脂代谢相关指标的水平,比较HUA组与非HUA组NAFLD检出率和脂代谢相关指标水平,并行相关性分析。结果 8 330例年龄中位数为43岁,四分位数间距为18岁;NAFLD总检出率为33.6%(2 795/8 330)。NAFLD组与非NAFLD组比较,NAFLD组的体重指数(body mass index,BMI)、腰高比(waist-to-stature ratio,WSR)、空腹血糖(blood glucose,GLU)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、尿酸(uric acid,UA)均升高,而高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)降低(P<0.05)。无论男性和女性,HUA组BMI、WSR、GLU、TC、TG、LDL-C、UA均较非HUA组升高,而HDL-C降低(P<0.05)。HUA组NAFLD检出率明显高于非HUA组(P<0.05)。Logistic回归分析和ROC曲线下面积分析结果显示HUA水平是NAFLD发生的危险因素。Spearman相关分析显示,HUA水平与BMI、WSR、GLU、TC、TG、LDL-C呈正相关,与HDL-C呈负相关。结论NAFLD与脂代谢紊乱关系密切,HUA是NAFLD的独立危险因素。

Objective To investigate the relationship among nonalcoholic fatty liver disease（NAFLD）,hyperuricemioa（HUA）,and dyslipidemias in checkup population.Methods A total of 8 330 healthy people who underwent health checkup were recruited in this study,who had met inclusion and exclusion standard.The demographic characteristics and detection condition of NAFLD were analyzed,indicators between NAFLD group and non-NAFLD group,indicators and detection rate of NAFLD between HUA group and non-HUA group were observed and compared.Results The median age of the 8 330 healthy people was 43 years old and the interquartile distance was 18 years.The total detection rate of NAFLD was 33.6%.Compared with those in non-NAFLD group,in NAFLD group,body mass index（BMI）,waist-to-stature ratio（WSR）,blood glucose（GLU）,serum total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）and uric acid（UA）level was significantly increased,while values of high density lipoprotein cholesterol（HDL-C）level were decreased（P〈0.01）.Whether the gender,in HUA group,BMI,WSR,GLU,TC,TG,LDL-C and UA levels were significantly increased,and HDL-C level was significantly decreased,and detection rates of NAFLD were significantly higher than Non-HUA group（P〈0.01）.Logistic regression analysis and area under the ROC curve showed that HUA level was an independent risk factor for NAFLD.Spearman′s correlation analyses showed a positive correlation between HUA and BMI,WSR,GLU,TC,TG,LDL-C and negative correlation between HUA and HDL-C.Conclusion NAFLD is closely related to dyslipidemias.HUA is an independent risk factor for NAFLD.