南平市人群血尿酸水平与非酒精性脂肪肝患病关系病例对照研究

Association between serum uric acid and non-alcoholic fatty liver disease risk among physical examinees:a case-control study

目的了解福建省南平市人群血尿酸水平与非酒精性脂肪肝(NAFLD)患病的关系,为NAFLD的预防控制提供参考依据。方法于2015年4月—2017年8月在南平市第一医院体检中心招募2328名年龄18~70岁的健康体检者进行问卷调查、体格检查和实验室检测,参照《中国非酒精性脂肪性肝病诊疗指南》(2010年修订版)中的影像学诊断标准将其中543例NAFLD患者和1785名未患NAFLD体检者分别作为病例组和对照组,分析血尿酸水平与NAFLD患病的关系。结果病例组NAFLD患者血尿酸水平为(375.24±93.36)μmol/L,高于对照组非NAFLD体检者血尿酸水平的(313.20±76.59)μmol/L(t=–15.664,P<0.001);按血尿酸值水平进行四分位数分组,血尿酸水平最低四分位数、第二四分位数、第三四分位数和最高四分位数者NAFLD的患病率分别为8.34%、23.52%、22.51%和43.13%;在调整了性别、年龄、文化程度、职业、月平均收入、吸烟情况、饮酒情况、体育锻炼频率、慢性病病史、体质指数、收缩压、舒张压、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、谷丙转氨酶、天门冬氨酸氨基转移酶、谷氨酰转肽酶、肌酐、空腹血糖等混杂因素后,多因素非条件logistic回归分析结果显示,血尿酸水平第二四分位数和最高四分位数者NAFLD的患病风险分别为最低四分位数者的2.05倍(OR=2.05,95%CI=1.35~3.11)和2.02倍(OR=2.02,95%CI=1.29~3.17)。结论高血尿酸水平可增加南平市人群NAFLD的患病风险。

Objective To explore the association between serum uric acid(SUA)and non-alcoholic fatty liver disease(NAFLD)among residents in Nanping city of Fujian province and to provide evidences for developing intervention on NAFLD.Methods We enrolled 2328 attendees aged 18–70 years at a physical examination center of a general hospital in Nanping city of Fujian province and conducted questionnaire interview,physical examination and laboratory detection among the participants from April 2015 through August 2017.In the participants,543 NAFLD cases were diagnosed based on imaging diagnostic criteria recommended by the National Guidelines for Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease–2010 Revision and assigned into the case group;the controls were 1785 participants without NAFLD.Statistical analyses were performed to assess the association of SUA with NAFLD.Results The SUA of the cases was significantly higher than that of the controls(375.24±93.36μmol/L vs.313.20±76.59μmol/L,t=–15.664;P<0.001).The detection rates of NAFLD were 8.34%,23.52%,22.51%,and 43.13%for the participants in the lowest,second,third,and the highest quartile of SUA content,respectively.Unconditional multivariate logistic regression analysis revealed that compared to those in the lowest quartile of SUA content,the participants in the second and the highest quartile were at increased risk of NAFLD,with the odds ratios(95%confidence interval)of 2.05(1.35–3.11)and 2.02(1.29–3.17)after adjusting for gender,age,education,occupation,monthly average income,smoking,alcohol drinking,physical exercise,history of chronic diseases,body mass index,systolic pressure,diastolic pressure,triglyceride,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,alanine aminotransferase,aspartate aminotransferase,glutamyltranspeptidase,creatinine,and fasting blood glucose.Conclusion High serum uric acid could increase the risk of non-alcoholic fatty liver disease in 18-70 years old population.