代谢正常肥胖个体发生非酒精性脂肪性肝病的相关性研究

目的:探讨代谢正常肥胖(Metabolically healthy obese,MHO)个体与非酒精性脂肪性肝病(Nonalcoholic fatty liver disease,NAFLD)发生的相关性。方法:选择2006年4月～2010年1月来湖南省人民医院体检中心体检人群共4076例,排除过量饮酒者、乙肝标志物阳性者及相关资料不全者共2830例纳入本研究。其中1367例在1～3年后再次体检。记录受检者身高、体重、血压、血脂、空腹血糖、腹部B超结果。NAFLD采用2010年中华医学会肝病学分会诊断标准中影像学诊断定义,行腹部B超检查进行诊断。结果:1.我院体检人群中MHO合并NAFLD者占51.34%,明显高于正常对照组(P=0.000),MHO组发生NAFLD的OR值为19.967(95%CI,12.646-31.533;P=0.000)。2.随访1～3年后,MHO中NAFLD发病率高于正常对照组(44.44%vs 7.02%,OR=10.600,95%CI,4.873-23.058;P=0.000)。结论:MHO个体合并NAFLD比例较正常对照者升高,MHO个体增加NAFLD患病风险。

Study on the Relation between Metabolically Healthy Obese and Nonalcoholic Fatty Liver Disease

Objective: To investigate the relation between metabolically healthy obese and nonalcoholic fatty liver disease.Methods: 4076 subjects were examined for routine health in People’s Hospital of Hunan Province from April 2006 to January 2010,2830 individual were enrolled excluding those with hepatitis B viruses,excessive alcohol consumption and missing data.1367 individual were followed up in 3 years.Data were collected of those individuals on body height,body weight,blood pressure,lipid profile and fast blood glucose.Diagnosis of NAFLD was made by B-ultrasound based on the criteria of Chinese Society of Hepatology of imaging diagnosis of NAFLD in 2010.Results: 1.The percentage of NAFLD in individuals with MHO was 51.34% in subjects with healthy examination in People’s Hospital of Hunan Province,which was significantly higher than that in normal controls(P=0.000).The presence of MHO was associated with an increased risk of NAFLD(OR=19.967;95%CI,12.646-31.533,P=0.000).2.Following up for 1 to 3 years,we found that the incidence of NAFLD in patients with MHO was significantly higher than that in normal controls(44.44% vs 7.02%,OR=10.600,95% CI,4.873-23.058,P=0.000).Conclusions: The percentage of NAFLD in individuals with MHO was significantly higher than that in normal controls,MHO may increase the risk of NAFLD.