健康查体人群非酒精性脂肪肝发病的相关危险因素分析

目的:探讨非酒精性单纯性脂肪肝以及由其演变的脂肪性肝炎各指标的差异,并分析非酒精性脂肪肝病(Nonalcoholic Fatty Liver Disease,NAFLD)的相关影响因素,为NAFLD防治提供依据。方法:入选病例分为正常组(A组,n=189)、单纯性脂肪肝组(B组,n=162)、脂肪肝伴肝功能改变组(C组,n=23),分析其体检结果及生活方式等影响因素,应用单因素及Logistic回归分析进行统计学处理。结果:C组大多数各项指标均比B组有所升高,其中体质量指数(BMI)、丙氨酸转氨酶(ALT)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)、空腹胰岛素(FIns)、餐后2小时胰岛素(2h PIns)差异有统计学意义(P0.05)。在B组和C组中ALT、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、Fins、2hPIns、腰臀比(WHR)与A组比较均有显著差异(P0.05);男性NAFLD的发病率比女性高,差异有统计学意义(x2=6.86,P0.05)。有高脂血症组单纯性脂肪肝发病率高于没有高脂血症组,差异有统计学意义(x2=26.11,P0.05)。有高血压病史的NAFLD发病率比无高血压病史的高,差异显著(x2=7.39,P0.05);Logistic回归分析显示,BMI、TC、HbA1c、有高血压病史是NAFLD的危险因素。结论:NAFLD与代谢综合征密切相关,NAFLD中伴肝功异常组存在更明显的胰岛素抵抗、血脂紊乱现象,更易于患慢性肾脏疾病。

Analysis of Risk Factors of Nonalcoholic Fatty Liver Diseasein People Undergoing Physical Examination

Objective:To investigate the differences of markers between nonalcoholic simple fatty liver (NAFL) and nonalcoholicsteatohepatitis (NASH) in people who were taking the physical examination, and to analyze the risk factors of nonalcoholic fatty liverdisease (NAFLD) so as to provide an evidence for NAFLD treatment.Methods:The cases were classified into groupA (control group,n=189), group B (NAFL, n=162) and groupC (NASH, n=23). The physical examination results and life style were analyzed. Theunivariate analysis and Logistic regression analysis was applied.Results:Most of the makers in group C were higher than that in group B.BMI, ALT, LDL-C, BUN, Fins and 2hPIns showed significant differences (P<0.05). HDL-C, TG, Fins, 2hPIns and WHR in group B andC were higher than that in groupA (P<0.05). The incidence of NAFLD was higher in male patients than female ones (X2=6.86, P<0.05).The prevalence of hypertension and hyperlipemia in NAFLD group was higher than that of control group (X2=26.11, P<0.05; X2=7.39,P<0.05). Logistic regression analysis revealed that BMI, TC, HbA1c and history of hypertension were the risk factors of NAFLD.Conclusion:NAFLD is closely associated with the metabolic syndrome and NASH group has more obvious phenomenon of dyslipidemiaof insulin resistance and easier to suffer fromchronic kidney disease than other groups.