上海市某社区老年人非酒精性脂肪性肝病患病率及危险因素分析

Prevalence and risk factors of nonalcoholic fatty liver disease among the elderly in a community of Shanghai

目的调查上海市某社区老年人中非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的患病率及探讨其危险因素,以期为防治方案的制定提供依据。方法搜集上海某社区2018年1月-2020年12月的健康体检资料,进行回顾性分析。根据指南诊断标准,将其分成NAFLD组和对照组。结果共搜集符合纳入和排除标准的资料2 755份,该社区老年居民NAFLD患病率为37.2%。单因素分析发现,NAFLD组与对照组相比,年龄、右侧收缩压、右侧舒张压、体重、身高、BMI指数及其分层、腰围、臀围、腰臀比,以及是否患有高血压、糖尿病、空腹血糖受损等指标之间存在统计学差异。二元Logistic模型多因素分析发现,随着年龄的增大,患有NAFLD风险下降(0<OR值<1,P<0.05);随着体质指数、臀围、血红蛋白、前白蛋白、三酰甘油、葡萄糖、低密度脂蛋白、谷丙转氨酶、总胆汁酸、碱性磷酸酶等指标的升高,发生NAFLD风险升高(OR值> 1,P<0.05)。结论上海某社区老年居民MAFLD患病率为37.2%,> 60岁以上的老年人群年龄是NAFLD保护因素,体质量指数、臀围、血红蛋白、前白蛋白、三酰甘油、葡萄糖、低密度脂蛋白是NAFLD危险因素。

Objective To investigate the prevalence of non-alcoholic fatty liver disease(NAFLD)among the elderly in a community in Shanghai city and explore its risk factors,in order to provide a basis for the formulation of prevention and treatment programs.Methods The physical examination data of a community in Shanghai city from January 2018 to December 2020 were collected and analyzed retrospectively.According to the guideline diagnostic criteria,they were divided into NAFLD group and control group.Results A total of 2755 data that met the inclusion and exclusion criteria were collected.The prevalence of NAFLD among the elderly in this community was 37.2%.Univariate analysis showed that there was stat-istical difference between NAFLD group and control group in age,right systolic blood pressure,right diastolic blood pressure,body weight,height,BMI index and its stratification,waist circumference,hip circumference,waist-to-hip ratio,and whether there were hypertension,diabetes,impaired fasting blood glucose.Multivariate analysis of the binary logistic model found that the risk of NAFLD decreased with age increased(0<0R value<1,P<0.05),and the risk of NAFLD increased with the increase of body mass index,hip circumference,hemoglobin,prealbumin,triacylglycerol,glucose,low density lipoprotein,alanine aminotransferase,total bile acid and alka-line phosphatase(OR value>1,P<0.05).Conclusion The prevalence of MAFLD among the elderly in the community in Shanghai city is 37.2%.In the elderly population over 60 years.old,age is a protective factor for NAFLD,and body mass index,hip circumference,hemoglobin,prealbumin,triacylglycerol,glucose,and low-density lipoprotein are risk factors for NAFLD.