沈阳市成年居民脂肪肝的流行病学调查  

An epidemiological survey of prevalence of fatty liver disease in a general adult population in Shenyang

作　　者：林连捷[1] 曹男[1] 郑长青[1] 林艳[1] 王东旭[1] 金玉[1] 

机构地区：[1]中国医科大学附属盛京医院消化内科,辽宁省沈阳市110004

出　　处：《世界华人消化杂志》2013年第12期1114-1119,共6页World Chinese Journal of Digestology

基　　金：辽宁省科学技术基金资助项目;No.2010225008;辽宁省博士科研启动基金资助项目;No.20081048;沈阳市科学技术基金资助项目;No.F10-205-1-17~~

摘　　要：目的:了解沈阳市成年居民脂肪肝的患病情况及相关危险因素.方法:选取2011-08/2011-11于我院体检的人员1100例,内容涉及问卷调查、体格检查、实验室检测及腹部超声检查.采用2010年中华医学会肝病学分会脂肪肝和酒精性肝病学组规定的脂肪肝诊断标准,统计被纳入对象的脂肪肝患病情况,并对其各项指标进行比较,分析其可能的危险因素.结果:沈阳市居民脂肪肝的患病率41.64%,男性患病率明显高于女性(45.15%vs37.45%,x2=6.557,P<0.05),研究发现41-50岁仍然是此病发病的高峰年龄段(47.92%),但21-30岁、31-40岁脂肪肝的患病率有明显增高趋势,分别占33.33%,46.25%.对比市内5区与大东区、于洪区、浑南新区及苏家屯区等地区的脂肪肝患病率,差异无显著性(x2=0.336,P>0.05).分析研究对象职业分布显示工人、公务员、普通职员脂肪肝发病率较高(x2=72.381,P<0.05).单因素分析显示,体质量指数(body mass index,BMI)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、尿酸(uric acid,UA)、甘油三酯(triglyceride,TG)、空腹血糖(fasting plasma glucose,FPG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)以及肝脏酶学指标,包括谷氨酰转肽酶(γ-glutamy ltranspeptidase,γ-GT)、天冬氨酸氨基转移酶(aspartate transaminase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)、碱性磷酸酶(alkaline phosphatase,ALP)均显著高于非脂肪肝组(均P<0.001).研究脂肪肝与BMI之间的关系我们发现随着体质量指数的增加,脂肪肝所占的比例呈明显增高趋势(x2=285.521,P<0.001).进一步多因素Logistic回归结果显示年龄、性别(男)、BMI、SBP、DBP、UA、ApoB、LDL-C、TG、FPG等9项指标与脂肪肝发病明显相关.结论:沈阳市居民脂肪肝的患病率较高,其中以中年人居多,并与性别、超体质量、肥胖、高血压、糖代谢紊乱、血脂异常、高尿酸血症等密切相关.AIM： To investigate the prevalence of and major risk factors for fatty liver in adult residents in Shenyang.METHODS： A total of 1？100 subjects who underwent physical examination in our center from August 2011 to November 2011 were included in this study. The survey included questionnaire investigation, physical examination, laboratory examination, and ultrasonic abdomen examination. The diagnosis of fatty liver disease was based on criteria adopted by the China Institute of Liver Disease and Alcoholic Liver Disease Group, and the prevalence of and major risk factors for fatty liver disease were investigated. RESULTS： The prevalence of fatty liver in 1？100 detected cases was 41.64%. Males had a higher prevalence than females （45.15% vs 37.45%, χ2 = 6.557, P 〈 0.05）. Age between 41 and 50 years was the peak age for the development of the disease （47.92%）, while the prevalence of fatty liver had a significantly increased trend in the age groups of 21-30 years and 31-40 years （33.33% and 46.25%）. The difference in the prevalence of fatty liver disease between the city＇s different regions was not significant （χ2 = 0.336, P 〉 0.05）. There was a higher incidence of the disease in workers, civil servants, and general staff （χ2 = 72.381, P 〈 0.05）. The mean age, body mass index （BMI）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, uric acid （UA）, triglycerides （TG）, fasting-serum glucose level （GLUO）, low-density lipoprotein cholesterol （LDL-C） and liver enzyme indicators （including γ-glutamyl transpeptidase, γ-GT, aspartate transaminase, （alanine aminotransferase and alkaline phosphatase） were significantly higher in the fatty liver group than in the group without fatty liver disease （χ2 = 285.521, P 〈 0.001）. The proportion of fatty liver was significantly increased with the increase in BMI. Logistic regression analysis demonstrated a close correlation between fatty liver disease and age, sex （male）, BMI, SBP, DBP, UA

关 键 词：脂肪肝 流行病学 危险因素 

分 类 号：R575.5[医药卫生—消化系统] R181.3[医药卫生—内科学]