新疆生产建设兵团农村维吾尔族居民非酒精性脂肪肝的发病情况和影响因素分析

Incidence and influencing factors of non-alcoholic fatty liver disease among rural Uyghur ethnic group residents in Xinjiang Production and Construction Corps

目的了解新疆生产建设兵团(新疆兵团)农村维吾尔族居民非酒精性脂肪肝(NAFLD)发病特征和影响因素,为当地居民早期识别和预防NAFLD提供科学依据。方法基于新疆兵团维吾尔族人群队列纳入研究对象10158人,采用前瞻性队列研究和Cox比例风险回归模型分析探讨NAFLD发病危险因素和聚集情况,通过限制性立方样条研究相关生化指标与NAFLD发病风险的剂量-反应关系。结果NAFLD累积发病率为6.9%,发病密度为12.06/1000人年,女性NAFLD发病密度高于男性(14.72/1000人年vs.9.17/1000人年,P<0.001),总人群以及男女性NAFLD发病密度均随着年龄增加而逐渐升高(均P<0.001);总人群初中及以上文化程度是NAFLD的保护因素,年龄较大、离异、丧偶、超重、肥胖、高血压、肾小球高滤过、HDL-C降低、LDL-C升高、ALT升高是NAFLD的危险因素,估计肾小球滤过率(eGFR)、HDL-C、LDL-C、ALT与NAFLD发病为非线性相关,且呈显著的剂量-反应关系;仅19.1%的居民无任何NAFLD危险因素,80.9%的居民有≥1种NAFLD危险因素,NAFLD发病风险随着危险因素数量增加而升高。结论新疆兵团农村维吾尔族居民发病率相对较低,但大部分居民有≥1种NAFLD危险因素,仍不能忽视对该人群NAFLD的预防控制。此外,年龄较大、离异、丧偶、文化程度较低、超重、肥胖者、高血压患者、eGFR、HDL-C、LDL-C和ALT等指标异常者是该人群中需重点关注的NAFLD高危人群。

Objective To investigate the incidence characteristics and influencing factors of non-alcoholic fatty liver disease(NAFLD)in rural Uyghur ethnic group residents in Xinjiang Production and Construction Corps and to provide scientific evidence for early identification and prevention of NAFLD for residents.Methods A total of 10158 participants were included from the Xinjiang Uygur ethnic group population cohort.A prospective cohort study and Cox proportional hazards regression model analysis were used to explore the influencing factors and clustering of NAFLD,and the dose-response relationship between related biochemical indicators and the risk of NAFLD was studied using a restricted cubic spline.Results The cumulative incidence rate of NAFLD was 6.9%,and the incidence density of NAFLD was 12.06/1000 person-years.The incidence density of NAFLD in females was higher than in males(14.72/1000 person-years vs.9.17/1000 person-years,P<0.001).The incidence density of NAFLD gradually increased with age in the total population,both men and women(all P<0.001).In the general population,an education level of junior high school or above was a protective factor for NAFLD,while older age,divorce,widowhood,overweight,obesity,hypertension,increased glomerular filtration rate,decreased HDL-C,increased LDL-C,and increased ALT were risk factors for NAFLD.Estimated glomerular filtration rate(eGFR),HDL-C,LDL-C,and ALT were non-linearly correlated with the incidence of NAFLD,and there was a significant dose-response relationship between them.Only 19.1%of residents had no NAFLD risk factors;over 80.9%had≥1 NAFLD risk factors.The risk of NAFLD increased with the number of risk factors.Conclusions The incidence of NAFLD in rural Uygur ethnic group residents in Xinjiang Production and Construction Corps was relatively low,but most residents had one or more risk factors for NAFLD.Prevention and control of NAFLD in this population cannot be ignored.In addition,people of older age,divorced or widowed,low education level,overweight or obese,hypertension,and abnormal eGFR,HDL-C,LDL-C,and ALT were the high-risk groups of NAFLD that need to be paid attention to in this population.