非酒精性脂肪性肝病对患者早期肾功能的影响及其性别差异

Effects of different sex patients with non-alcoholic fatty liver disease on early renal dysfunctionin

目的探讨非酒精性脂肪性肝病对早期肾功能的影响及其性别差异。方法选取2020年1~6月健康体检人群,共获取有效样本2045例,记录年龄、性别、身高、体重、收缩压(SBP),舒张压(DBP)等一般资料,同时检测血脂、血糖、肝功、肾功、钙、磷、空腹血糖(FBG)及肝脏超声,计算体重指数(BMI)和肾小球滤过率(eGFR)。结果男性EGFR与年龄、SBP、血肌酐(CREA)、尿素氮(BUN)、血尿酸(SUA)、胱抑素(Cys)-C、总胆红素(TBIL)呈负相关,与高密度脂蛋白胆固醇(HDL)、谷丙转氨酸(ALT)、γ-谷胱氨酰转肽酶(GGT)、胆碱酯酶(CHE)、磷(P)呈正相关。女性GFR与年龄、BMI、SBP、DBP、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL)、谷草转氨酸(AST)、GGT、CREA、BUN、SUA、CHE、前白蛋白(PA)、Cys-C、CO_(2)-CP、Ca、TBIL、间接胆红素(DBIL)呈负相关,与HDL-C、白蛋白(ALB)、ALB/GLB呈正相关;女性未调整时NAFLD组低GFR的患病危险是无NAFLD组的2.955倍(95%CI 1.579~5.531),调整年龄、肥胖因素等后NAFLD组低GFR患病危险是无NAFLD组的2.484倍(95%CI 1.039~5.940)。结论女性GFR降低与血脂异常有相关性,而男性仅与HDL具有相关性,更重要的是患有NAFLD的女性比健康女性更易出现GFR降低,而患有NAFLD男性组未发现此结果。

Objective To investigate the effect of non-alcoholic fatty liver disease on early renal function and its gender differences.Methods The healthy physical examination population was selected as the research object.A total of 2045 valid samples were obtained,and the age(Age),gender,height,body mass and systolic blood pressure(SBP),diastolic blood pressure(DBP)and other general information were recorded,also blood lipids,blood sugar,liver function,renal function,calcium,phosphorus,fasting blood glucose(FBG)and liver ultrasound were detected,body mass index(BMI)and glomerular filtration rate(GFR)were calculated.Results Compared with the abnormal rates of various indicators between the different genders and among the different GFRs,male GFR was negatively correlated with Age,SBP,DBP,CREA,BUN,SUA,Cys-C,TBIL,and positively correlated with HDL,ALT,GGT,CHE.Female GFR was negatively correlated with Age,BMI,SBP,DBP,TC,TG,LDL,AST,GGT,CREA,BUN,SUA,CHE,TP,Cys-C,CO2-CP,Ca,TBIL,DBIL,and positively correlated with HDL,ALB,and ALB/GLB;the risk of low GFR in the NAFLD group was 2.955 times that of the non-NAFLD group(95%CI:1.579~5.531)for women without adjustment,the disease risk was 2.484 times(95%CI:1.039~5.940)of the non-NAFLD group after Age and BMI adjustment.Conclusions GFR reduction in the females is correlated with dyslipidemia,while that in the males is only correlated with HDL.More importantly,females with NAFLD are more likely to have the reduced GFR than healthy females,but this result is not found in males with NAFLD.