非酒精性脂肪性肝病伴发胆囊疾病的风险因素分析

Analysis of risk factors for non-alcoholic fatty liver disease with gallbladder disease

[目的]探讨非酒精性脂肪性肝病(NAFLD)与胆囊疾病相关性。[方法]回顾性分析健康体检人群9082例,根据腹部彩超结果分为NAFLD组(n=2408),健康对照组(n=6674),再根据不同年龄段将以上人群分为18~29岁亚组、30~49岁亚组、50~69岁亚组与≥70岁亚组,根据体质指数≥25分为肥胖亚组与非肥胖亚组,收集资料包括性别、年龄、代谢综合征组分(血糖、尿酸、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、体质指数),胆囊疾病(胆囊结石、胆囊息肉),对以上因素进行单因素和多因素回归分析。[结果]NAFLD检出率为26.51%。在30~49岁年龄段中,胆囊息肉多见于女性非肥胖NAFLD,胆囊结石在男女非肥胖、肥胖NAFLD亚组中均多见。多因素logistic回归分析模型诊断符合率为85.4%,结果显示年龄增长、男性、体质指数、尿酸、血糖、三酰甘油、低密度脂蛋白为独立危险因素(OR值=1.041,1.373,1.543,1.004,1.188,1.527,1.614),胆囊息肉、胆囊结石与NAFLD发病关系密切(OR值=1.342,1.362)。[结论]NAFLD与代谢综合征密切相关,NAFLD易合并胆囊结石和(或)胆囊息肉。

[Objective]To analyze the relationship between non-alcoholic fatty liver disease(NAFLD)and its complicated biliary diseases.[Methods]A retrospective analysis of 9082 healthy people in the PLA Rocket Forces Characteristic Medical Center from July 2013 to April 2019 were divided into NAFLD group(n=2408)and healthy control group(n=6674)according to the results of abdominal color doppler ultrasound.According to different age groups,the above population were divided into 18-29 years old subgroup,30-49 years old subgroup,50-69 years old subgroup and 70 years old subgroup;according to the body mass index≥25,they were divided into the obese subgroup and the non-obese subgroup.The general information including gender,age,components of metabolic syndrome(blood glucose,uric acid,triacylglycerol,total cholesterol,high-density lipoprotein,low-density lipoprotein,body mass index),gallbladder disease(gallbladder stones,gallbladder polyps)were collected,single factor and multi-factor regression analysis were conducted for the analysis of above factors.[Results]The prevalence rate of NAFLD was 26.51%.In the age group of 30 to 49 years old,gallbladder polyps were more common in female non-obese NAFLD,gallbladder stones in both male and female,non-obese and obese NAFLD subgroups were more common.The diagnostic coincidence rate of the multivariate logistic regression analysis model was 85.4%,the results showed that age increase,male,body mass index,uric acid,blood glucose,triacylglycerol,and low density lipoprotein were independent risk factors,gallbladder polyps and gallbladder stones were closely related to the incidence of NAFLD.[Conclusion]NAFLD is closely related to metabolic syndrome,and gallbladder stones and/or gallbladder polyps are easily associated with NAFLD.