延安地区成人脂肪肝患病率及其危险因素的探讨  

An epidemiological survey of prevalence and risk factors for fatty liver disease in adults residing in Yan'an,China

作　　者：乔丽娜[1] 戴光荣[1] 张锦[1] 申妮[1] 

机构地区：[1]延安大学附属医院消化内科,陕西延安716000

出　　处：《临床肝胆病杂志》2015年第1期82-87,共6页Journal of Clinical Hepatology

摘　　要：目的调查并探讨延安地区成人脂肪肝的患病率及其主要危险因素。方法收集延安大学附属医院2011年2月-2013年3月资料完整的健康体检者,均接受人体学测量(身高、体质量、血压)、生化及免疫学检查(肝功能、血糖、血脂、血尿酸、肾功能、病毒标志物)及超声检查。资料分析采用t检验、χ2检验及Logistic回归分析法。结果共6236例健康体检者参与调查研究,约占延安市人口的3.76‰。其中男3532例,女2704例,平均(49.27±12.93)岁。B超共检出脂肪肝1602例,占25.69%,其中酒精性、可疑酒精性、非酒精性脂肪肝分别占4.55%、7.08%及88.37%。脂肪肝组肥胖、高血压、高尿酸血症、空腹血糖过高、糖尿病、血脂异常患病率等均显著高于非脂肪肝组。多元回归分析显示:年龄、男性、饮酒、腰围、身体质量指数(BMI)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、尿酸(UA)、空腹血糖、糖尿病、高血压病是脂肪肝的危险因素,其中HDL-C是脂肪肝的保护因素。空腹血糖调节受损组及糖尿病组较血糖正常组相比脂肪肝患病风险分别增加了1.584、2.638倍(P值均<0.001);超重、Ⅰ度肥胖、Ⅱ度肥胖组与正常体质量组相比脂肪肝患病风险分别增加了1.627、1.796、9.544倍(P值均<0.001);适量饮酒、过量饮酒组与无饮酒组相比,脂肪肝患病风险分别增加1.638、3.648倍(P值均<0.001);肥胖加饮酒组较无肥胖和饮酒组相比,脂肪肝患病风险增加了17.672倍(P<0.001)。收缩压、舒张压、UA、TG、总胆固醇(TC)、LDL-C增高组及HDL-C降低组较正常组相比脂肪肝患病风险分别增加了1.835、1.768、1.821、4.524、1.569、1.824、2.724倍,差异具有统计学意义(P<0.05)。其中以TG及HDL-C异常的危险性增加最为明显。结论延安地区成人脂肪肝患病率偏高,主要为非酒精性脂肪肝,性别、年龄、肥胖、饮酒、糖代谢紊乱、高尿�Objective To investigate the prevalence and major risk factors for fatty liver disease among adult residents in Yan’an,Shanxi Province,China.Methods The study enrolled healthy adults who had physical examination with complete clinical records in our hospital from February 2011 to March 2013.All participants underwent anthropometric measurement （height,weight,and blood pressure）,bio-chemical and immunological tests （liver and renal function;blood glucose,lipids,and uric acid [UA];viral markers）,and ultrasound ex-amination.Data analysis was performed using the t test,χ2 test,and logistic regression analysis.Results A total of 6236 adult residents participated in the survey,who accounted for approximately 3.76/1000 of the total population in Yan’an.There were 3532 males and 2704 females,with a mean age of 49.27 ＆#177;12.93 years.Fatty liver disease was detected with ultrasound examination in 1602 participants （25.68%）,among whom alcoholic,suspected alcoholic,and nonalcoholic forms accounted for 4.55%,7.08%,and 88.37%,respective-ly.The fatty liver group had a significantly higher prevalence of obesity,hypertension,hyperuricemia,higher-than-normal fasting serum glucose （FSG）level,diabetes mellitus,and dyslipidemia than the non -fatty -liver group （P〈0.001 ）.Multiple regression analysis showed that age,gender （male）,drinking,waist circumference,body mass index,high-density lipoprotein cholesterol （HDL-C）,low-density lipoprotein cholesterol （LDL-C）,triglyceride （TG）,UA,FSG,diabetes mellitus,and hypertension were influential factors for fatty liver disease,of which HDL-C was a protective factor.Compared with the normal FSG group,the impaired fasting glycaemia and dia-betes groups were at an increased risk for fatty liver disease by 1.584-and 2.638-fold,respectively （P〈0.001）.The risk increased by 1.627-,1.796-,9.544-fold,respectively,in the overweight,grade I obesity,and gradeⅡobesity groups versus the normal weight group （P 〈0.001）,by 1.638-and 3.648-fold in the

关 键 词：脂肪肝 患病率 危险因素 延安 

分 类 号：R575.5[医药卫生—消化系统]