上海某社区老年人非酒精性脂肪肝的患病情况及影响因素分析

Analysis of the prevalence of nonalcoholic fatty liver disease in the elderly people and influencing factors in a community of Shanghai

目的:分析社区老年人群非酒精性脂肪肝(NAFLD)的患病情况及相关影响因素,为在社区开展NAFLD的防治工作提供依据。方法:采用整群抽样方法,在2019年参加曲阳路街道社区卫生服务中心组织的免费体检的信息中收集到符合纳入标准的6257名60岁及以上老年人的信息,其中男性3190人,平均年龄(73.04±6.82)岁,女性3067人,平均年龄(74.93±7.33)岁。分析NAFLD的患病情况及影响因素。结果:在6257名老年居民中,经腹部彩超检出NAFLD 3070人,患病率为49.07%,其中男性患病率明显高女性(53.89%比44.05%,P<0.001),NAFLD的患病率随着年龄的增长呈下降趋势(P<0.001)。Logistic回归分析显示:年龄、性别、体重指数、腰围、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、空腹血糖、收缩压、舒张压与NAFLD的患病相关。结论:控制NAFLD的重点在于预防。社区全科医生在临床工作中应重视健康教育,纠正社区居民不良生活方式,及时纠正体重、血脂、血糖、血压等指标的异常,减少NAFLD的患病风险。

Objective:To analyze the prevalence of nonalcoholic fatty liver disease(NAFLD)in the elderly and the related influencing factors in the community,so as to provide evidence for NAFLD prevention and control in the community.Methods:The cluster sampling method was used to collect information of 6257 seniors aged 60 and above who met the inclusion criteria in the free medical examination organized by Quyanglu Community Health Service Center in 2019 and among them,3190 were male with an average age of(73.04±6.82)years,and 3067 were female with an average age of(74.93±7.33)years.The prevalence of NAFLD and influencing factors were analyzed.Results:Among 6257 elderly residents,3070 people with NAFLD were detected by color Doppler ultrasound,the prevalence rate was 49.07%,among them,the prevalence of the males was significantly higher than that of the females(53.89%vs.44.05%,P<0.001),and the prevalence of NAFLD decreased with age(P<0.001).Logistic regression analysis showed that age,gender,body mass index,waist circumference,total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,fasting blood glucose,systolic blood pressure,and diastolic blood pressure were related to the disease of NAFLD.Conclusion:The key point of controlling NAFLD is prevention.In clinical work,community general practitioners should pay attention to health education,correct the bad life style of community residents,and the abnormality of weight,blood lipid,blood glucose,blood pressure and other indicators in time to reduce the risk of NAFLD.