空腹血糖受损合并非酒精性脂肪性肝病患者的危险因素分析

Analysis of risk factors of patients with impaired fasting glucose complicated with non-alcoholic fatty liver disease

目的分析上海市浦东新区老港社区卫生服务中心参加体检的空腹血糖受损(IGT)合并非酒精性脂肪性肝病(NAFLD)患者的临床特点,并探讨其相关危险因素。方法以406例50岁及以上体检诊断为IGT的患者为研究对象,根据B超检查结果分为IGT合并NAFLD组(合并组,232例)、IGT未合并NAFLD组(非合并组,174例),比较两组的基线资料,分析IGT合并NAFLD的相关危险因素。结果合并组女性比例、合并高血压比例、舒张压、体质量指数(BMI)、空腹血糖(FPG)、甘油三酯(TG)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清肌酐(Ccr)、血清尿酸(SUA)均高于非合并组,而年龄、高密度脂蛋白胆固醇低于非合并组,差异有统计学意义(P<0.05);两组间收缩压、总胆固醇、低密度脂蛋白胆固醇比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示女性(OR=5.337,95%CI:2.990~9.526)、BMI高(OR=1.702,95%CI:1.504~1.926)、TG升高(OR=1.168,95%CI:0.994~1.373)、FPG升高(OR=3.175,95%CI:1.054~9.559)是IGT合并NAFLD的独立危险因素(P<0.05)。结论IGT合并NAFLD患者以女性居多,BMI更高,糖脂代谢紊乱更严重。需加强对IGT人群(尤其是女性)的体质量管理、预防血脂异常,降低NAFLD的发生风险。

Objective To analyze the clinical characteristics and related risk factors of patients with impaired fasting glucose(IGT)complicated with nonalcoholic fatty liver disease(NAFLD).Methods A total of 406 patients who participated in the physical examination and diagnosis of IGT person with 50 or more than 50 years old were divided into IGT combined with NAFLD group(combined group,232 cases)and IGT without NAFLD group(non-combined group,174 cases)according to the results of B-ultrasound.The baseline data of the two groups were compared in the two groups and the related risk factors of IGT combined with NAFLD patients were analyzed.Results The proportion of females and hypertension,diastolic blood pressure,body mass index(BMI),fasting blood glucose(FPG),triglyceride(TG),alanine aminotransferase(ALT),glutamate aminotransferase(AST),serum creatinine(Ccr)and serum uric acid(SUA)in the combined group were higher than those in the non-combined group.Age and high density lipoprotein cholesterol were lower than those in the non-combined group,the differences were statistically significant(P<0.05).There was no significant difference on systolic blood pressure,total cholesterol and low density lipoprotein cholesterol between the two groups(P>0.05).Multivariate Logistic regression analysis showed that female(OR=5.337,95%CI:2.990-9.526),BMI increased(OR=1.702,95%CI:1.504-1.926),TG increased(OR=1.168,95%CI:0.994-1.373)FPG increased(OR=3.175,95%CI:1.054-9.559)were independent influencing factors of IGT combined with NAFLD(P<0.05).Conclusion The majority of patients with IGT complicated with NAFLD are women,with higher BMI and more serious disorder of glucose and lipid metabolism.It is necessary to strengthen the weight management of IGT population(especially women),prevent and treat dyslipidemia,and reduce the risk of NAFLD.