社区老年高血压人群中血细胞参数与非酒精性脂肪肝的关系

Association of blood cell parameters with non-alcoholic fatty liver disease in the elderly with hypertension

目的探讨社区老年高血压人群中血细胞参数与非酒精性脂肪肝(NAFLD)的关系,以期为预测老年高血压人群非酒精性脂肪肝的发生提供参考。方法于2018年4—7月,以村/居委为单位,采取整群抽样方法抽取浦东新区某社区年龄≥60岁的老年高血压患者,建立社区健康体检档案并进行体格检查、实验室检查收集身高、体重、血压、血细胞参数等相关资料。采用多因素logistic回归分析研究血细胞参数与非酒精性脂肪肝的关系。结果老年高血压患者NAFLD检出率为63.29%(2 041/3 225)。非酒精性脂肪肝组淋巴细胞绝对值、淋巴细胞比率、单核细胞绝对值、中性粒细胞绝对值、白细胞计数、红细胞计数、红细胞比容、血红蛋白、平均血红蛋白浓度、血小板计数水平均高于正常组(均P<0.05),非酒精性脂肪肝组中性粒细胞比率、红细胞分布宽度、平均红细胞体积水平均低于正常组(均P<0.05)。调整性别、年龄、体重指数和空腹血糖后,红细胞分布宽度过低,单核细胞绝对值、淋巴细胞绝对值、红细胞计数、血红蛋白过高是非酒精性脂肪肝的危险因素(均P<0.05)。结论老年高血压人群中,红细胞分布宽度、淋巴细胞绝对值、红细胞计数、血红蛋白、单核细胞绝对值水平与非酒精性脂肪肝相关,这可能为预测老年高血压人群非酒精性脂肪肝的发生提供新的思路。

Objective This study aimed to investigate the relationship between blood cell parameters and non-alcoholic fatty liver disease(NAFLD) in the elderly with hypertension and provide scientific evidence for the prevention and control of NAFLD in elderly hypertensive patients. Methods The cluster sampling method was adopted to select elderly people aged over 60 years who were diagnosed with hypertension from April to July 2018 by taking the village or committee as a unit. After establishing community health examination files, physical examination and laboratory examination were conducted to collect blood cell parameters and other data. Multivariate logistic regression was used to analyse the relationship between blood cell parameters and NAFLD. Results The detection rate of NAFLD in elderly patients with hypertension was 63.29%(2 041/3 225). The level of absolute lymphocyte, leukomonocyte, absolute monocyte, absolute neutrophil count, white blood cell count, red blood cell count, haematocrit, haemoglobin, mean corpuscular haemoglobin concentration and platelet count in the NAFLD group was higher than that in the normal group(all P<0.05). The level of neutrophile granulocyte, red blood cell distribution width and mean corpuscular volume in the NAFLD group was lower than that in the normal group(all P<0.05). After adjusting for gender, age, BMI and fasting glucose, red blood cell distribution width was negatively associated with NAFLD, and absolute lymphocyte, absolute monocyte, haemoglobin and red blood cell count were positively associated with NAFLD(all P<0.05). Conclusion Our results suggest that red cell distribution width, absolute lymphocyte, red blood count, absolute monocyte and haemoglobin were associated with NAFLD, which may provide a new way to prevent and control NAFLD in elderly hypertensive patients.