非肥胖型与肥胖型非酒精性脂肪性肝病进展性肝纤维化临床特点分析

Clinical characteristics of non-obese and obese patients with nonalcoholic fatty liver disease and advanced fibrosis

目的:探究非肥胖型与肥胖型非酒精性脂肪性肝病(NAFLD)进展性肝纤维化患者的临床特点。方法:选取2019年9月至2020年6月在我院肝病门诊诊断为NAFLD进展性肝纤维化的患者91例,并按BMI分为非肥胖型组18例和肥胖型组73例,另选取同期健康体检者35例为对照组。比较3组一般资料与实验室检查结果。结果:与非肥胖型组比较,肥胖型组BMI、ALT、TG、GLU水平及合并糖尿病、高脂血症比例更高,男性比例更低(P<0.05)。与对照组相比,非肥胖型组ALT、AST、GLU、TG水平、腰围及合并糖尿病、高脂血症比例均增高,而PLT、ALB、H-DLC水平、BMI及男性比例降低(P<0.05)。结论:非肥胖型与肥胖型NAFLD进展性肝纤维化患者均存在糖类和脂类代谢紊乱,非肥胖型患者虽然没有肥胖这一危险因素,但仍存在其他的危险因素,值得临床重视。

Objective:To investigate the clinical characteristics of non-obese and obese patients with nonalcoholic fatty liver disease(NAFLD)and advanced fibrosis.Methods:Ninety-one patients diagnosed with NAFLD and advanced fibrosis in our hepatology clinic from September 2019 to June 2020 were selected and divided into non-obese group(n=18)and obese group(n=73)according to BMI,and another 35 healthy subjects during the same period were selected as control group.General data and laboratory findings were compared among the three groups.Results:Compared with the non-obese group,the levels of BMI,ALT,TG and GLU,and the proportion of diabetes and hyperlipidemia in the obese group were increased,while the proportion of males were decreased(P<0.05).Compared with the control group,the levels of ALT,AST,GLU and TG,waist circumference,and the proportion of diabetes and hyperlipidemia in the non-obese group were increased,while the PLT,ALB,H-DLC levels,BMI,and the proportion of males were decreased(P<0.05).Conclusion:Both non-obese and obese patients with NAFLD and advanced fibrosis have carbohydrate and lipid metabolism disorders.Although non-obese patients don't have obesity as a risk factor,they still have other risk factors,which is worthy of clinical attention.