非酒精性脂肪性肝病和代谢综合征的临床特征比较及危险因素探讨  

The Clinical Features and Risk Factors of NAFLD vs MS

作　　者：张利莉[1] 袁莉[1] 李琴[1] 汪英[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院内分泌科,武汉430022

出　　处：《华中科技大学学报（医学版）》2010年第2期189-192,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：湖北省自然科学基金资助项目(No.2005ABA158)

摘　　要：目的比较非酒精性脂肪性肝病（NAFLD）与代谢综合征（MS）的临床特征差异并探讨分析相关危险因素。方法选取在华中科技大学同济医学院附属协和医院进行健康体检者共1107人,分为单纯代谢综合征组（MS组）,单纯非酒精性脂肪性肝病组（NAFLD组）,非酒精性脂肪性肝病合并代谢综合征组（MN组）及无MS及NAFLD组（对照组）。所有个体均检测身高、体重、腰围、血压、血糖、血脂、肝脏B超。脂肪肝诊断标准依据中华医学会肝脏病学会建议标准,代谢综合征使用国际糖尿病联盟（IDF 2005）建议标准。结果MS、NAFLD及MN组中高血压、糖尿病、高血脂病的患病率及服用阿司匹林的人数比例均高于对照组,差异有显著性意义（P〈0.05或P〈0.01）。MS组血压、腰围、腰臀比及TG均显著高于NAFLD组（P〈0.05或P〈0.01）。MN组BMI、TC及TG显著高于MS组（P〈0.05或P〈0.01）,血压、BMI、腰围、腰臀比、空腹血糖、糖化血红蛋白、TG均显著高于NAFLD组（P〈0.05或P〈0.01）。腰围、ALT及TG为3组共同的独立危险因素（OR波动于1.03~1.81,P〈0.01）,而BMI为NAFLD及MN的共同独立危险因素（OR分别为1.25及1.34,P〈0.01）,收缩压、空腹血糖及LDL-C为MS及MN两组的共同独立危险因素（OR波动于1.02~1.74,P〈0.01）。结论NAFLD与MS代谢异常组成成分（如腹型肥胖、高血压、高血糖、高血脂等）及程度类似,而两者合并存在时代谢异常程度更明显,严重的腹型肥胖及TG升高为人群同时患MS及NAFLD的最强危险因素。Objective To investigate the clinical features and risk factors of non-alcoholic fatty liver disease（NAFLD） vs metabolic syndrome（MS）.Methods The subjects were assigned to four groups：those only with MS（MS）;those only with NAFLD（NAFLD）;those with both of the two diseases（MN）;those with neither of the two diseases（control）.Questionnaire about medical record,diet,sport and family history was conducted,and fast plasma sugar,lipid profile,body mass index（BMI）,waist circumference（WC） as well as blood pressure was measured.Diagnosis of NAFLD was based on the criteria suggested by Chinese Society of Hepatology,and that of MS by its components following the 2005 International Diabetes Federation（IDF） criteria.Results The prevalence of hypertension,diabetes,hyperlipemia and aspirin taking history was higher in MS,NAFLD and MN than that in control group（P0.05 or P0.01）.The blood pressure,waist circumference,waist-to-hip ratio and TG were significantly increased in MS group as compared with those in NAFLD group（P0.05 or P0.01）.The BMI,TC and TG were significantly increased in MN group as compared with those in MS group（P0.05 or P0.01）.The blood pressure,BMI,waist circumference,waist-to-hip ratio,fast blood sugar,glycosylated hemoglobin and TG were significantly increased in MN group as compared with those in NAFLD group（P0.05 or P0.01）.All of the three groups of NAFLD,MS and MN shared the common independent risk factors which were waist circumference,ALT and TG（OR=1.03-1.81,P0.01）.BMI was the common independent risk factor of NAFLD and MN（OR=1.25 and 1.34 respectively）.Systolic pressure,fast blood sugar and LDL-C were the common independent risk factors of NAFLD and MN（OR=1.02-1.74,P0.01）.Conclusion The components and extent of metabolic abnormality were similar between NAFLD and MS.Both of the abdominal obesity and hypertriglyceridemia were strong predictors of NAFLD with MS.

关 键 词：代谢综合征 非酒精性脂肪性肝病 危险因素 腹型肥胖 

分 类 号：R58[医药卫生—内分泌]