饮酒、肥胖与脂肪肝关系的流行病学调查  

Epidemiologically survey on relation of fatty liver with alcohol drinking and obesity

作　　者：范建高[1] 朱军[1] 李新建[2] 李锐[2] 戴菲[3] 宋晓敏 刘天舒[5] 李锋[1] 陈世耀[5] 

机构地区：[1]上海交通大学附属第一人民医院脂肪肝诊治中心,200080 [2]上海市疾病预防控制中心慢性病科 [3]上海第二医科大学公共卫生学院 [4]杨浦区中心医院防保科 [5]复旦大学附属中山医院循证医学中心

出　　处：《肝脏》2005年第3期179-181,共3页Chinese Hepatology

摘　　要：目的探讨饮酒、肥胖与脂肪肝的关系。方法通过随机多级分层整群抽样,对上海市成人进行问卷调查、体检、血糖、血脂和B超检查。结果3175名调查对象中月饮酒率、肥胖、脂肪肝检出率分别为7.62%、41.9%和20.82%。661例脂肪肝中,非酒精性占92.43%、酒精性仅占3.48%。与对照组相比,过量饮酒和肥胖分别增加脂肪肝患病风险3.6倍(95%CI,1.1～11.7)和11.6倍(95%CI,8.2～16.5),而过量饮酒合并肥胖则增加脂肪肝患病风险17.1倍(95%CI,9.1～32.4);肥胖增加过量饮酒者脂肪肝患病风险4.8倍(95%CI,1.4～16.6),而过量饮酒并不能显著增加肥胖患者脂肪肝患病风险(OR=1.5,95%CI,0.9～2.6)。结论上海市成人脂肪肝患病率高且以非酒精性为主,肥胖与脂肪肝的关系较过量饮酒与脂肪肝的关系更为密切。Objective To investigate relation of fatty liver with alcohol drinking and obesity. Methods Using randomized multistage stratified cluster sampling, investigations including questionnaires, physical examinations, oral glucose tolerance tests, blood lipid tests, and real - time liver ultrasonographics subjects were adults age over the 16 in 8 residential areas of Shanghai city. Results 3 175 adults were enrolled consisted of 1 218 males and 1 426 females, with a mean age of 52.4 ± 15.1 years. The prevalence of drinking monthly and obesity were 7.62 % and 41.9 %, respectively. Ultrasonography detected fatty liver in 661 （20.82 % ） cases： 3.48 % were alcoholic fatty liver, and 92.43 % were nonalcoholic fatty liver. Compared with controls, the risk for fatty liver was higher by 3.6 fold（95% CI, 1.1 - 11.7） in heavy drinkers, 11.6 fold（95% CI, 8.2 - 16.5） in obese persons, and 17.1 fold（95% CI, 9.1 - 32.4） in persons who were both obese and heavy drinking. In heavy drinkers, obesity increased the risk for fatty liver by 4.8 fold （95 % CI, 1.4 - 16.6）, but heavy drinking not significantly （95 % CI, 0.9 - 2.6） increased the risk for fatty liver in obese subjects. Conclusion There is a high prevalence of fatty liver, predominantly nonalcoholic fatty liver, in the adult population of Shanghai. Obesity and associated multiple metabolic disorders are more closely related to fatty liver than excessive drinking.

关 键 词：饮酒量 生活习惯 肥胖 脂肪肝 流行病学 病理机制 

分 类 号：R575.5[医药卫生—消化系统] R589.2[医药卫生—内科学]