上海市松江区新桥镇65岁及以上居民非酒精性脂肪性肝病的发病与恢复

Incidence and recovery of nonalcoholic fatty liver disease among residents aged 65 years old and above in Xinqiao Town,Songjiang District,Shanghai

【目的】分析上海市新桥社区≥65岁老年居民非酒精性脂肪性肝病(NAFLD)的发病、恢复情况及影响因素,为进一步高效开展社区管理提供基础数据。【方法】收集2016—2022年上海市松江区新桥社区≥65岁老年人体检资料,以参加≥2次体检的居民为研究对象。将数据整理为纵向形式,第1次体检数据作为基线,后续体检视作随访。计算NAFLD的发病密度和恢复密度。通过Cox回归分析探讨NAFLD发病和恢复的相关因素,并探讨相关因素对NAFLD发病和恢复的影响。【结果】共11983位居民参加过老年体检,其中参加≥2次者8644人,无过量饮酒史者8154人。基线B超数据提示无脂肪肝5267人,脂肪肝2887人。中位随访3.3年后,估计该人群NAFLD发病密度为11.5例·(100人·年)^(-1),恢复密度为23.4例·(100人·年)^(-1)。NAFLD发病密度与年龄增长呈负相关,与基线高BMI、腹型肥胖、高空腹血糖和高甘油三酯呈正相关;恢复密度与基线高BMI、腹型肥胖负相关。相较基线与随访体重指数(BMI)保持正常者,持续肥胖对象NAFLD发病风险最高(男性风险比HR:3.19,95%CI:2.16~4.70;女性HR:3.34,95%CI:2.46~4.54),恢复可能最低(男性HR:0.58,95%CI:0.42~0.82;女性HR:0.58,95%CI:0.44~0.77)。持续高甘油三酯也与高发病风险相关。【结论】上海市松江区新桥社区≥65岁居民NAFLD发病率和恢复率均较高。老年人中女性、肥胖和高血脂人群是NAFLD发生和持续的高危人群。

[Objective]To analyze the incidence,recovery rate and associated factors of nonalcoholic fatty liver disease(NAFLD)among residents aged 65 years old and above in Xinqiao Community of Songjiang,Shanghai,and to provide basic data for further efficient community management.[Methods]Data of annual geriatric physical examination program for residents aged 65 and above were collected in Xinqiao Community,Songjiang from 2016 to 2022.Those residents who participated twice or more were included in this analysis.Data were collated into longitudinal form.For each participant,data of the first physical examination was used as baseline,and each subsequent examination was taken as follow-up.Incidence and recovery rate of NAFLD were calculated.Cox proportional hazard models were used to explore the associated factors and their changes with the onset and recovery of NAFLD.[Results]During the study period,a total of 11983 residents participated in physical examinations,of which 8644 participated twice or more,and 8154 had no history of excessive alcohol consumption.B-ultrasound showed that there were 5267 residents without NAFLD and 2887 with NAFLD at baseline.After a median follow-up of 3.3 years,the incidence density of NAFLD in this population was estimated to be 11.5 per 100 person-years,and the recovery density was 23.4 per 100 person-years.The incidence density of NAFLD was negatively associated with age,and positively associated with baseline BMI,abdominal obesity,high fasting blood glucose,and high triglycerides.The recovery density was negatively associated with baseline BMI and abdominal obesity.Compared with those with normal BMI at both baseline and follow-up,those with persistent obesity showed the highest risk of NAFLD(males:HR:3.19,95%CI:2.16−4.70;females:HR:3.34,95%CI:2.46−4.54)and the lowest potential of recovery(males:HR:0.58,95%CI:0.42−0.82;females:HR:0.58,95%CI:0.44−0.77).Persistently high triglycerides were also associated with a higher risk of developing the disease.[Conclusion]Residents aged 65 years old and above in Xinqiao,Shanghai had a higher incidence and recovery rate of NAFLD.Women,being obese and having hyperlipidemia are at a higher risk for the development and persistence of NAFLD.