社区中老年人群中上臂围与非酒精性脂肪性肝病及胰岛素抵抗的相关性研究  

Association between mid-upper arm circumference and non-alcoholic fatty liver disease or insulin resistance in middle-aged and elderly Chinese community population

作　　者：侯亚楠 禤立平 彭魁[1] 杜瑞[1] 徐瑜[1] 陈宇红[1] 陆洁莉[1] 毕宇芳[1] 徐敏[1] 王卫庆[1] 宁光[1] 

机构地区：[1]国家代谢性疾病临床医学研究中心上海市内分泌代谢病研究所上海交通大学医学院附属瑞金医院内分泌代谢病科,上海200025

出　　处：《上海交通大学学报（医学版）》2017年第9期1231-1237,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81471062);上海市教育委员会高峰高原学科建设计划(20152508)~~

摘　　要：目的·探讨社区中老年人群中上臂围(MUAC)与非酒精性脂肪性肝病(NAFLD)及胰岛素抵抗的相关性。方法·选取2014年上海市嘉定区6 570名40岁以上居民,进行标准化问卷调查、体格检查、生化检测及高分辨率超声检查。在排除其他肝脏疾病和过量饮酒后,按照腹部B超检查结果诊断NAFLD。按照MUAC四分位数分组,分析MUAC与NAFLD及胰岛素抵抗的相关性。结果·随着MUAC的增粗,男女2组受试者的身体质量指数(BMI)、腰围、收缩压、舒张压、三酰甘油、空腹胰岛素、胰岛素抵抗水平、低密度脂蛋白胆固醇、谷丙转氨酶、γ-谷氨酰转肽酶、谷草转氨酶水平均逐渐增加(均P<0.01);NAFLD、高血压病、血脂异常、胰岛素抵抗的患病风险也呈现显著增加的趋势(均P<0.01)。Logistic回归分析显示,校正年龄、目前吸烟、体力活动、BMI、腰围及主要代谢指标后,随着MUAC的增大,在女性人群中NAFLD及胰岛素抵抗的患病风险均显著增加,而在男性中MUAC与NAFLD及胰岛素抵抗无相关性。结论·在社区中老年人群中女性MUAC与NAFLD及胰岛素抵抗呈独立正相关。Objective： To investigate the association between mid-upper arm circumference （MUAC） and non-alcoholic fatty liver disease （NAFLD） or insulin resistance in middle-aged and elderly Chinese community population. Methods. A cross-sectional study was conducted in 6 570 residents aged 40 years or older in Jiading District of Shanghai in 2014. All participants received standard questionnaire, anthropometric measurements, biochemical evaluation and ultrasonic examination. NAFLD was defined by hepatic ultrasonography, after excluding subjects with excess alcohol consumption and medical history of liver diseases. Participants were divided into 4 groups according to the quartiles of MUAC, then association between MUAC and NAFLD or insulin resistance was analyzed. Results- With the increase of MUAC level, body mass index （BMI）, waist circumference, systolic blood pressure, diastolic blood pressure, triacylglycerol, fasting insulin, HOMA-IR levels, low-density lipoprotein-cholesterol, alanine aminotransferase, T-glutamyl transpeptidase, and aspartic transaminase levels were increased significantly （all P〈0.01）, as well as the prevalence of NAFLD, hypertension, dyslipidemia, and insulin resistance （all P〈0.01）. A fully adjusted multivariate Logistic regression analysis revealed that with the increase of MUAC level, the risk of having NAFLD and insulin resistance were increased among women. However, among men, there was no correlation between MUAC and NAFLD or insulin resistance. Conclusion · MUAC is significantly associated with NAFLD and insulin resistance in middle-aged and elderly female Chinese community population.

关 键 词：中上臂围 非酒精性脂肪性肝病 胰岛素抵抗 中老年人群 

分 类 号：R575.5[医药卫生—消化系统]