非酒精性脂肪性肝病患者的肝功能和代谢情况的分析

Analysis of liver function and metabolism in patients with non-alcoholic fatty liver disease

目的分析体检人群中非酒精性脂肪性肝病(NAFLD)患者的肝功能及代谢异常发生情况。方法选取2019年1月—12月在苏州大学附属第一医院健康管理中心进行体检的11041例体检者,男6935例,女4106例,年龄(49.9±12.9)岁,年龄范围为20~97岁。所有体检者均于清晨空腹测量身高、体质量、血压,计算体质量指数(BMI),测定空腹血糖、糖化血红蛋白(HbA1c)、甘油三酯、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血尿酸;同时进行腹部超声及颈部血管超声检查。结果3316例体检者患有NAFLD,其中男2697例,女619例。男女发病例数比较,差异有统计学意义(P<0.01)。各年龄段男性NAFLD的发病率均显著高于女性,差异有统计学意义(P<0.01)。根据体检者是否患有NAFLD分为NAFLD组和非NAFLD组,NAFLD组超质量或肥胖、高血压、糖尿病、空腹血糖升高、HbA1c升高、ALT升高、甘油三酯升高、总胆固醇升高、LDL-C升高、HDL-C降低、血尿酸升高、颈动脉斑块发生率均显著高于非NAFLD组,差异有统计学意义(P<0.01)。多因素分析显示,年龄、性别(男性)、BMI、高血压、糖尿病、空腹血糖升高、HbA1c升高、甘油三酯升高、LDL-C升高、HDL-C降低与NAFLD的发生密切相关。结论年龄、性别(男性)、超质量或肥胖、高血压、高血糖、高血脂是脂肪肝发生的主要危险因素,同时也是心脑血管病发病的危险因素,控制脂肪肝对预防心脑血管病也有积极意义。

Objective To analyze the liver function and the metabolism in patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 11041 medical examinees were selected by our hospital from January 2019 to December 2019.There were 6935 males and 4106 females,aged(49.9±12.9)years old,raging from 20 to 97 years old.Height,weight pressure,body mass index(BMI),fasting plasma glucose,glycosylated hemoglobin(HbA1c),triacylglycerol,total cholesterol,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterin(LDL-C),alanine aminotransferase(ALT),aspartic acid amino transferase(AST)and serum uric acid were mesured.Abdominal ultrasound and cervical vascular ultrasound were performed.Results NAFLD was diagnosed in 3316 patients,including 2697 males and 619 females.Compared the number of the infected males and females,the difference was statistically significant(P<0.01).The morbidity of males in different age compared with females,the difference was statistically significant(P<0.01).According to whether or not NAFLD,the patients were divided into NAFLD group and non-NAFLD group.Overweight or obesity,hypertension,diabetes,increased fasting plasma glucose,increased HbA1c,high ALT,high triacylglycerol,increased total cholesterol,increased LDL-C,decreased HDL-C,increased serum uric acid and the incidence of carotid plaque in NAFLD groupwere higher than non-NAFLD group,the difference was statistically significant(P<0.01).Multivariate analysis showed,the age,male,BMI,hypertension,diabetes,increased fasting plasma glucose,increased HbA1c,increased triacylglycerol,increased LDL-C,decreased HDL-C were closely related to the occurence of NAFLD.Conclusion Age,male,overweight or obesity,hypertension,hyperglycemia,and hyperlipidemia are the main risk factors for fatty liver development,and also the risk factors for the development of cardiovascular and cerebrovascular diseases.Controlling fatty liver is positive significance for the prevention of cardiovascular and cerebrovascular diseases.