长沙体检人群身体质量指数与脂肪肝关系的探讨

Relationship between body mass index and fatty liver among physical examination population in Changsha

目的 分析身体质量指数(body mass index, BMI)与脂肪肝的关系,明确发生脂肪肝的BMI临界值,以便及时识别并干预脂肪肝高危人群。方法 收集2020年1月—2021年8月在湖南省人民医院健康管理中心进行体检的成年人健康体检资料24 019例,根据我国目前超重和肥胖标准分成体重过轻组、正常组、超重组和肥胖组,使用二元logistic回归分析评估四组患脂肪肝的风险,利用受试者工作特征曲线(receiver operator characteristic curve, ROC曲线)判断发生脂肪肝的BMI临界值。结果 (1)本次所选取长沙地区体检人群的脂肪肝患病率为35.64%;(2)二元logistic回归分析矫正混杂因素后显示超重组和肥胖组患脂肪肝的风险分别是正常组的2.946倍和9.168倍(P<0.05),表明BMI增高是脂肪肝的独立危险因素;(3)超重组和肥胖组患脂肪肝的风险在不同的甘油三酯和高密度脂蛋白胆固醇水平中存在差异(P_(交互作用)<0.05)。(4)ROC曲线显示,男性发生脂肪肝的BMI临界值为24.60,曲线下面积(area under curve, AUC)为0.814,女性发生脂肪肝的BMI临界值为23.20,AUC为0.848。结论 BMI增高是脂肪肝的独立危险因素,对脂肪肝有一定的预测价值,当男性BMI>24.60、女性BMI>23.20时,应重视体重管理,以减少脂肪肝的发生。

Objective To analyze the relationship between body mass index(BMI) and fatty liver, to clarify the BMI cut-off value of fatty liver so as to intervene the high-risk groups in time. Methods We collected the physical examination data about 24,019 adults undergoing medical check-ups in the Health Management Center of Hunan Provincial People’s Hospital from January 2020 to August 2021. According to the current overweight and obesity standards in China, they were divided into the underweight group, the normal group, the overweight group and the obese group. Binary logistic regression analysis was used to evaluate the risk of fatty liver in the four groups. The receiver operator characteristic(ROC) curve was used to determine the BMI cut-off value of fatty liver. Results The prevalence rate of fatty liver among the subjects undergoing physical examination in Changsha was 35.64%. After correction for confounding factors in binary logistic regression analysis, the results showed that the risk of fatty liver in the overweight and obese groups was 2.946 times and 9.168 times higher than that of the normal group(both P<0.05), respectively, indicating that the elevated BMI was an independently risk factor for fatty liver. The risk of fatty liver disease in the overweight and obese groups varied by different triglyceride and high density liptein cholesterol levels(P_(interaction)<0.05). The ROC curve revealed that the cut-off value of BMI for fatty liver in males was 24.60, and the area under curve(AUC) 0.814. The cut-off value of BMI for fatty liver in females was 23.20, and the AUC 0.848. Conclusion The elevated BMI is an independent risk factor for fatty liver, which has a certain predictive value for fatty liver. When male BMI is more than 24.60 and female BMI more than 23.20, special attention should be paid to weight management so as to reduce the occurrence of fatty liver.