中重度非酒精性脂肪肝与冠心病的相关性

Relationship Between Moderate and Severe Non-Alcoholic Fatty Liver Disease and Coronary Artery Disease

目的探讨中重度非酒精性脂肪肝(NAFLD)与冠心病的相关性。资料与方法回顾性收集行CT冠状动脉造影及腹部CT扫描且临床资料齐全的103例患者,以37例肝脾CT值比值≤0.7为中重度NAFLD组,66例肝脾CT值比值>0.7作为对照组。比较两组患者冠心病构成比、病史、血脂水平及用药史的差异,分析冠心病的独立危险因素。结果中重度NAFLD合并冠心病构成比为64.9%(24/37),高于对照组的18.2%(12/66;χ^2=22.726,P<0.01)。两组患者病史、血脂水平及用药史差异均无统计学意义(P均>0.05)。多因素Logistic回归分析结果显示,中重度NAFLD(OR=8.764,95%CI 2.893~26.546)、年龄(OR=1.099,95%CI 1.031~1.172)、糖尿病(OR=2.921,95%CI 1.019~8.372)及高血压病史(OR=6.878,95%CI 1.390~34.029)是冠心病的独立危险因素(P均<0.05)。结论中重度NAFLD在冠心病中比例更高,是冠心病的独立危险因素。

Purpose To explore the relationship between moderate and severe non-alcoholic fatty liver disease(NAFLD)and coronary artery disease(CAD).Materials and Methods A total of 103 patients with complete clinical data and underwent CT coronary angiography and abdominal CT scan were retrospectively collected.37 cases with liver and spleen CT value ratio≤0.7 was defined as moderate to severe NAFLD,and 66 cases with liver and spleen CT value ratio>0.7 as the control group.The constituent ratio of CAD,blood lipid level and medication history were compared between the two groups,and the independent risk factors of CAD was also analyzed.Results The proportion of CAD in moderate and severe NAFLD patients was 64.9%(24/37),which was statistically higher than 18.2% of the control group(12/66;χ^2=22.726,P<0.01).No significant difference in medical history,blood lipid level and medication history between the two groups were observed(all P>0.05).Logistic multivariate analysis showed that moderate to severe NAFLD,age,diabetes mellitus and hypertension were independent risk factors for CAD(all P<0.05),the corresponding odds ratio was 8.764(95%CI 2.893-26.546),1.099(95%CI 1.031-1.172),2.921(95%CI 1.019-8.372)and 6.878(95%CI 1.390-34.029),respectively.Conclusion The proportion of CAD patients in moderate to severe NAFLD is higher,moderate to severe NAFLD is the independent risk factor for CAD.