高尿酸与肥胖的交互作用对非酒精性脂肪肝病患病率的影响

The effect of the interaction between hyperuric acid and obesity on the prevalence of non-alcoholic fatty liver disease

目的研究高尿酸(UA)和肥胖的交互作用对非酒精性脂肪肝病(NAFLD)患病率的影响。方法采用病例对照的研究法,选取2021年1月至2021年12月兰州市某医院健康体检中心进行常规健康体检的504人为研究对象,按照诊断标准分为NAFLD组187人和非NAFLD组317人。采用Logistic回归模型、相乘、相加交互模型探讨非酒精性脂肪肝病患病风险的影响因素及因素间的交互作用。结果多因素条件Logistic回归分析可知,肥胖(OR=4.87,95%CI:3.01~7.89),糖尿病患者(OR=3.40,95%CI:1.51~7.68),幽门螺杆菌(Hp)携带者(OR=1.62,95%CI:1.03~2.57),高尿酸血症的NAFLD患病风险增加,分别是正常者、非糖尿病患者、非Hp携带者,非高尿酸血症的4.87倍,3.40倍,1.62倍,2.28倍,在调整混杂因素后交互作用结果显示,高尿酸血症和肥胖对NAFLD患病率有相乘交互作用(OR=0.30,95%CI:0.10~0.88,P=0.029)、但无相加交互作用(相对超额危险度比=3.15、归因比=0.24、协同指数=1.34)。结论BMI、糖尿病、Hp是NAFLD患病的独立危险因素,其中高尿酸血症和超重与肥胖对NAFLD患病有相乘交互作用,无相加交互作用。

Objective To explore the influence of the interaction of high uric acid(UA)and obesity on the prevalence of non-alcoholic fatty liver disease(NAFLD).Methods Using a case-control study method,504 people who underwent routine health checkups at the health checkup centre of a hospital in Lanzhou City from January 2021 to December 2021 were enrolled in the study,and 187 people were included in the NAFLD group and 317 people in the non-NAFLD group according to the diagnostic criteria.Logistic regression models,multiplicative and additive interaction models were used to investigate the factors affecting the risk factors of NAFLD and the interaction between the factors.Results Multifactorial conditional logistic regression analysis showed that the risk of NAFLD was increased in obese(OR=4.87,95%CI:3.01-7.89),diabetic patients(OR=3.40,95%CI:1.51-7.68),Helicobacter pylori(Hp)carriers(OR=1.62,95%CI:1.03-2.57);the increased risk of NAFLD prevalence in hyperuricaemia patients was 4.87,3.40,1.62,and 2.28 times higher than that of normal,non-diabetic,non-Hp carriers,and non-hyperuricemic individuals,respectively.And the adjusted interaction showed a multiplicative interaction of hyperuricaemia and obesity on the prevalence of NAFLD after controlling for the confounders(OR=0.30,95%CI:0.10-0.88,P=0.029),but no additive interaction(relative excess risk due to interaction=3.15,attributable proportion due to interaction=0.24,and synergy index=1.34)interactions.Conclusions BMI,diabetes mellitus,and Hp were independent risk factors for the prevalence of NAFLD,with hyperuricaemia and overweight and obesity having multiplicative interaction and no additive interaction.