尿液pH值和非酒精性脂肪性肝病的相关性研究

Association between urinary pH value and non-alcoholic fatty liver disease

目的:研究中老年人群尿液pH值和非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的相关性。方法:采取整群抽样的方法对上海市嘉定社区8292名40岁以上的常住居民进行问卷调查、体格检查、生化检测和高分辨率超声检查。NAFLD的诊断依据高分辨率超声扫描结果。尿液pH值≤5.5定义为低尿液pH值。采用Cochran-Armitage检验分析不同尿液pH值分组间NAFLD患病率的变化趋势。采用Logistic回归分析低尿液pH值与NAFLD的相对危险度。结果:与正常人群相比,NAFLD患者的体质量指数(body mass index,BMI)、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting blood glucose,FPG)、空腹胰岛素、胰岛素抵抗指数、丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,GGT)、高血压患病率、低尿液pH值比例显著升高,而高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)则显著降低(均P<0.01)。随着尿液pH的升高,NAFLD的患病率逐渐下降(趋势P<0.01)。Logistic回归分析表明,与尿液pH值正常人群相比,低尿液pH值者NAFLD的患病风险在男女2组内分别增加了26.3%[优势比(odds ratio,OR)=1.263,95%可信区间(confidence interval,CI):1.002~1.593]和21.8%(OR=1.218,95%CI:1.046~1.417)(P<0.05)。结论:在中老年人群中,低尿液pH值与NAFLD的患病风险呈显著相关性。

Objective To study the correlation between urinary pH value and non-alcoholic fatty liver disease(NAFLD)in middle-aged and elderly people.Methods A questionnaire survey,physical examination,biochemical tests and high-resolution ultrasonography were performed on 8292 subjects over 40 years old in Jiading community of Shanghai.NAFLD was diagnosed by high-resolution hepatic ultrasonography.Urinary pH value≤5.5 was defined as low urinary pH value.The Cochran-Armitage test was used to analyze the trend of the prevalence of NAFLD among individuals with different urinary pH value.Logistic regression was performed to explore the effect of low urinary pH value on the risk of NAFLD.Results Except for high-density lipoprotein cholesterol,individuals with NAFLD had higher body mass index systolic blood pressure,diastolic blood pressure,total cholesterol,low-density lipoprotein cholesterol,fasting blood glucose,fasting insulin,insulin resistance index,alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transpeptidase,hypertension prevalence and low urinary pH value ratio than those without NAFLD(P<0.01).The prevalence of NAFLD decreased along with increment of urinary pH value accordingly(P<0.01).Logistic regression analysis demonstrated that low urinary pH value was associated with an increased risk of NAFLD.Compared to subjects with normal urinary pH value,the odds ratio(OR)[95%confidence interval(CI)]of subjects with low urinary pH value for NAFLD was 1.263(1.002-1.593)in men and 1.218(1.046-1.417)in women respectively.Conclusions In the middle-aged and elderly population,low urinary pH value is significantly associated with an increased risk of NAFLD.