瘦型非酒精性脂肪性肝病的影响因素分析

Influencing factors for lean non-alcoholic fatty liver disease

目的研究瘦型非酒精性脂肪性肝病(NAFLD)的影响因素,为瘦型NAFLD的防治提供参考。方法于2023年1月1日—2024年3月31日,在湖州市中心医院体检者中,采用方便抽样法抽取体质指数(BMI)<23 kg/m^(2)的体检者进行调查。通过问卷收集人口学信息、生活方式、饮食习惯和健康体检资料;采用腹部超声和BMI评估瘦型NAFLD。采用多因素logistic回归模型分析瘦型NAFLD的影响因素。结果调查627人,BMI为(20.83±2.01)kg/m^(2)。男性349人,占55.66%;女性278人,占44.34%。检出瘦型NAFLD 74例,检出率为11.80%。多因素logistic回归分析结果显示,BMI(OR=1.830,95%CI:1.165~2.869)、性别(男,OR=2.615,95%CI:1.402~4.875)、三酰甘油(OR=3.062,95%CI:1.613~5.812)、丙氨酸氨基转移酶(OR=1.587,95%CI:1.106~2.277)、蔬果摄入(150~300 g/d,OR=0.416,95%CI:0.230~0.752;>300 g/d,OR=0.303,95%CI:0.141~0.649)、奶制品摄入(≥300 mL/d,OR=0.369,95%CI:0.195~0.701)和含糖饮料摄入(1~250 mL/d,OR=1.601,95%CI:1.071~2.393;>250 mL/d,OR=2.438,95%CI:1.363~4.354)是瘦型NAFLD的影响因素。结论瘦型NAFLD与BMI、性别、三酰甘油、丙氨酸氨基转移酶及蔬果、奶制品、含糖饮料摄入有关。

Objective To investigate the factors affecting lean non-alcoholic fatty liver disease(NAFLD),so as to pro⁃vide the reference for the prevention and treatment of lean NAFLD.Methods Individuals who underwent physical exami⁃nation at Huzhou Central Hospital from January 1,2023 to March 31,2024 and had a body mass index(BMI)<23 kg/m^(2)was selected.Demographic information,lifestyle behaviors,dietary habits and physical examination data were collected through questionnaire surveys.Lean NAFLD was assessed using abdominal ultrasonography combined with BMI.Factors affecting lean NAFLD were analyzed by using a multivariable logistic regression model.Results A total of 627 individ⁃uals were surveyed,with a mean BMI of(20.83±2.01)kg/m^(2).There were 349 males(55.66%)and 278 females(44.34%).Lean NAFLD was detected in 74 cases,with a detection rate of 11.80%.Multivariable logistic regression analysis identified BMI(OR=1.830,95%CI:1.165-2.869),gender(male,OR=2.615,95%CI:1.402-4.875),triglycerides(OR=3.062,95%CI:1.613-5.812),alanine aminotransferase(OR=1.587,95%CI:1.106-2.277),vegetable and fruit intake(150-300 g/d,OR=0.416,95%CI:0.230-0.752;>300 g/d,OR=0.303,95%CI:0.141-0.649),dairy product intake(≥300 mL/d,OR=0.369,95%CI:0.195-0.701)and sugared beverage intake(1-250 mL/d,OR=1.601,95%CI:1.071-2.393;>250 mL/d,OR=2.438,95%CI:1.363-4.354)as factors affecting lean NAFLD.Conclusion The risk of lean NAFLD is associated with BMI,gender,triglyceride,alanine aminotransferase,and the vegetable and fruit,dairy product and sugared beverage intake.