非酒精性脂肪性肝病与颈动脉内中膜厚度的关系  

Relations between Nonalcoholic Fatty Liver Disease and Carotid Artery Intima-media Thickness

作　　者：李小明[1] 李锋[1] 杨津[1] 朱鹏立[1] 

机构地区：[1]福建省立医院老年病房,福州350001

出　　处：《福建医科大学学报》2011年第2期137-139,142,共4页Journal of Fujian Medical University

摘　　要：目的探求非酒精性脂肪性肝病(NAFLD)与动脉粥样硬化之间(AS)的关系。方法 122例超声诊断为NAFLD患者与135例年龄、性别配比的对照者,分别测量颈动脉内-中膜厚度及斑块及血脂、血糖、肝功能、体质指数等参数。结果 NAFLD患者的颈动脉内-中膜厚度明显高于对照组[(0.81±0.24)mmvs(0.56±0.18)mm,P<0.01],检出率(54.8%)明显高于对照组(17.0%),差别有统计学意义(P<0.01)。NAFLD患者的腰围、体质指数、低密度脂蛋白胆固醇、甘油三酯、空腹血糖、胰岛素抵抗指数、谷丙转氨酶、谷氨酸转肽酶均明显高于对照组(P<0.05或P<0.01),而高密度脂蛋白低于对照组(P<0.05)。Logistic回归分析显示,校正主要的危险因素后,NAFLD是颈动脉斑块的独立危险(OR=3.65,P<0.01)。结论 NAFLD是动脉粥样硬化的危险因素,其促动脉粥样硬化的作用可能是独立于代谢综合症等传统因素之外的。Objective To explore the relationship between nonalcoholic fatty liver and carotid atherosclerosis.Methods We compared carotid IMT,as assessed by ultrasonography,in 122 patients withultrasonography-proven NAFLD and 135 normal persons,without a prior diagnosis of diabetes,hypertension,and cardiovascular disease,matched for sex,age.Results A significant difference in mean values of intima-media thickness[（0.81±0.24） mm vs（0.56±0.18）mm,P〈0.01]and prevalence of plaques [63（54.8%） and 23（17.0%）,P〈0.01]was observed in nonalcoholic fatty liver disease patients and the control group respectively.Waist circumference,body mass index,low-density lipoprotein cholesterol,fasting glucose,triglycerides and HOMA-insulin resistance in NAFLD group were higher than those in the control group（P〈0.05 and P〈0.01,respectively）.However,high-density-lipoprotein cholesterol（HDL） were lower than that in control group（P〈0.01）.Logistic regression,after adjusting for the main risky factors,NAFLD-associated adjusted odds ratio for plaque,defined as IMT1.5 mm,were 3.65（95%CI： 2.02～6.58;P〈0.01） compare with subjects without NAFLD.Conclusion These results suggest that NAFLD may be risky factors of carotid atherosclerosis independent of multiple metabolic abnormalities.

关 键 词：脂肪肝 酒精性 颈动脉疾病 血管内膜 动脉粥样硬化 

分 类 号：R575.5[医药卫生—消化系统]