某岛礁官兵脂肪肝患病现况调查及影响因素分析

Prevalence and influencing factors of fatty liver among officers and soldiers on a certain island

目的根据某岛礁官兵体检超声检查结果分析其肝胆疾病患病现状和脂肪肝影响因素。方法回顾性纳入2021年377例某岛礁官兵体检数据,采集其年龄、性别、生活习惯、腹部超声结果及肝功能检验结果等资料,分析肝胆疾病患病情况。采用单因素和多因素Logistic回归分析筛选脂肪肝的影响因素,采用受试者操作特征(ROC)曲线分析影响因素对脂肪肝的预测价值。结果共有103例官兵诊断出患有肝胆疾病,其中位居前三位的依次为脂肪肝65例(63.11%,65/103)、胆囊息肉20例(19.42%,20/103)和肝血管瘤9例(8.74%,9/103),占所有肝胆疾病总例数的91.27%(94/103),占参与体检总例数的24.93%(94/377)。患有脂肪肝(65例)与未患脂肪肝(312例)的官兵年龄、体重指数(BMI)、是否有吃宵夜习惯相比较差异均有统计学意义(P<0.01)。患有脂肪肝和未患脂肪肝的官兵肝功能检验指标中丙氨酸转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(T⁃Bil)、直接胆红素(D⁃Bil)、γ⁃谷氨酰转移酶(γ⁃GT),以及葡萄糖(Glu)、甘油三酯(TG)差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,ALT、Glu、TG、BMI、吃宵夜习惯是脂肪肝的独立影响因素(P<0.05)。ALT、Glu、TG、BMI和吃宵夜习惯预测脂肪肝的ROC曲线下面积(AUC)分别为0.776、0.621、0.764、0.828、0.637,五者组合模型的曲线下面积为0.866。结论某岛礁官兵脂肪肝患病率较高(17.24%,65/377),ALT、Glu、TG、BMI和吃宵夜习惯可作为脂肪肝的组合诊断模型。为了尽早防治脂肪肝,应对该人群饮食、运动、训练方法进行全流程系统化综合管理,控制相关危险因素,对高危人群进行危险因素干预和治疗,切实改善岛礁官兵身心健康。

Objective To investigate the current status of liver and gallbladder diseases and analyze the influencing factors of fatty liver based on the ultrasound examination results of officers and soldiers on a certain island.Methods The data of physical examination from 377 officers and soldiers on a certain island in 2021 were retrospectively analyzed.Age,gender,living habits,abdominal ultrasound results,and liver function test results were collected,and the incidence of liver and gallbladder diseases were investigated.Univariate and multivariate logistic regression analyses were used to screen the influencing factors of fatty liver disease.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of influencing factors for fatty liver disease.Results A total of 103 officers and soldiers were diagnosed with liver and gallbladder diseases.The top three were fatty liver(63.11%,65/103),gallbladder polyps(19.42%,20/103),and liver hemangioma(8.74%,9/103),accounting for 91.27%(94/103)of the subjects with liver and gallbladder diseases and 24.93%(94/377)of all the subjects undergoing physical examination.There were significant differences in the age,body mass index(BMI),the habit of mid night snacks,liver function indexes(alanine aminotransferase[ALT],aspartate aminotransferase[AST],total bilirubin[T⁃Bil],direct bilirubin[D⁃Bil],gamma⁃glutamyltransferase[γ⁃GT]),glucose(Glu),and triglyceride(TG)between the officers and soldiers with fatty liver(65 cases)and without fatty liver(312 cases)(all P<0.01).Multivariate logistic regression analysis showed that ALT,Glu,TG,BMI and the habit of midnight snacks were independent influencing factors of fatty liver(all P<0.05).The area under the ROC curve values of ALT,Glu,TG,BMI,the habit of midnight snacks and their combination in prediction of fatty liver were 0.776,0.621,0.764,0.828,0.637 and 0.866,respectively.Conclusion There is a high prevalence of fatty liver in officers and soldiers on a certain island(17.24%,65/377).ALT,Glu,TG,BMI and the habit of midnight snack can be used as a combined diagnostic model of fatty liver.The diet,exercise and training methods should be systematically and comprehensively managed to control related risk factors.Risk factor intervention and treatment should be carried out for high⁃risk population to effectively improve the physical and mental health of officers and soldiers on the island.