瘦型与肥胖型代谢相关脂肪性肝病患者的临床特征比较

Comparison of clinical characteristics of lean and obese patients with metabolic associated fatty liver disease

目的比较瘦型与肥胖型代谢相关脂肪性肝病(MAFLD)患者的临床特征。方法选择2019年6月至2020年12月南通市第三人民医院收治的198例MAFLD患者为研究对象,根据体质量指数(BMI)将患者分为瘦型MAFLD组(n=42)和肥胖型MAFLD组(n=156),收集2组患者的临床资料,对2组患者的临床资料进行比较。结果瘦型MAFLD组患者男性所占比例显著高于肥胖型MAFLD组,年龄、BMI、游离三碘甲状腺原氨酸显著低于肥胖型MAFLD组,白蛋白、尿酸、总胆固醇显著高于肥胖型MAFLD组(P<0.05);其余指标2组间比较差异无统计学意义(P>0.05)。瘦型MAFLD组中合并高血压、冠状动脉性心脏病、空腹血糖受损/糖尿病、高尿酸血症、甲状腺功能减退患者的比例均显著高于肥胖型MAFLD组(P<0.05);2组中合并高胆固醇血症、高三酰甘油血症患者的比例比较差异无统计学意义(P>0.05)。瘦型MAFLD组患者肝脏硬度值显著低于肥胖型MAFLD组(P<0.05);2组患者的肝脏脂肪衰减参数比较差异无统计学意义(P>0.05)。结论与肥胖型MAFLD患者相比,瘦型MAFLD患者中男性比例更高,患者年龄更轻,合并高血压、糖尿病、甲状腺功能减退等代谢相关并发症概率更高。

Objective To compare the clinical characteristics of lean and obese patients with metabolic associated fatty liver disease(MALFD).Methods A total of 198 patients with MALFD admitted to the Third People′s Hospital of Nantong from June 2019 to December 2020 were selected as the research objects.The patients were divided into lean MALFD group(n=42)and obese MALFD group(n=156)according to the body mass index(BMI).The clinical data of patients in the two groups were collected and compared.Results The proportion of male patients in the lean MALFD group was significantly higher than that in the obese MALFD group(P<0.05);the age,BMI and free triiodothyronine of patients in the lean MALFD group were significantly lower than those in the obese MALFD group(P<0.05);the levels of albumin,uric acid and total cholesterol of patients in the lean MALFD group were significantly higher than those in the obese MALFD group(P<0.05);there was no significant difference in other indexes of patients between the two groups(P>0.05).The proportion of patients with hypertension,coronary heart disease,impaired fasting glucose/diabetes,hyperuricemia and hypothyroidism in the lean MAFLD group were significantly higher than those in the obese MAFLD group(P<0.05);there was no significant difference in the proportion of patients with hypercholesterolemia and hypertriglyceridemia between the two groups(P>0.05).The liver stiffness measurement of patients in the lean MALFD group was significantly lower than that in the obese MALFD group(P<0.05);there was no significant difference in controlled attenuation parameter of patients between the two groups(P>0.05).Conclusion Compared with obese MAFLD patients,the proportion of male patients in lean MAFLD patients is higher,the age is younger,and the probability of patients with metabolic complications such as hypertension,diabetes and hypothyroidism are higher.