腹腔内脂肪面积正常的非酒精性脂肪性肝病的危险因素分析  

Risk factors of nonalcoholic fatty liver disease with a normal visceral adipose tissue area

作　　者：黄志鹏[1] 蒋建家[2] 黄子成[1] 郭桂元[1] 周阿佩 刘晓强 HUANG Zhipeng;JIANG Jianjia;HUANG Zicheng(Department of Gastroenterology,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院消化内科,福建泉州362000 [2]福建医科大学附属泉州第一医院内分泌科,福建泉州362000

出　　处：《临床肝胆病杂志》2019年第5期1061-1064,共4页Journal of Clinical Hepatology

基　　金：泉州市第一医院青年科研课题(2014-QN-03)

摘　　要：目的明确腹腔内脂肪面积(VAT)正常的非酒精性脂肪性肝病(NAFLD)的危险因素及其胰岛素抵抗(IR)状态。方法选取2017年6月-2018年5月福建医科大学附属泉州第一医院收集的45例VAT正常的NAFLD患者为观察组,另取同期27例VAT正常且非NAFLD者作为对照组。分别测定2组对象的VAT、腰围、空腹血糖(FBG)、空腹胰岛素(FINS)等指标,计算IR指数(HOMA-IR),并分析IR与腰围等指标的相关性。正态分布的计量资料2组间比较采用独立样本t检验,非正态分布者采用Mann-Whitney U检验,计数资料2组间比较采用χ~2检验。正态分布的计量资料相关性比较采用Pearson相关分析,非正态分布者采用Spearman相关分析。危险因素分析采用logistic回归分析(向前法)。结果 VAT正常的NAFLD组IR水平较对照组高,HOMA-IR2组间差异有统计学意义[2. 66(1. 59～4. 06) vs 1. 84(1. 25～2. 47),Z=364. 000,P=0. 005]; IR与FBG、FINS、TG呈正相关,r值分别为0. 412、0. 789、0. 306(P值<0. 05),与HDL呈负相关(r=-0. 398,P <0. 05)。多因素回归分析显示,腰围为VAT正常NAFLD的独立危险因素,回归系数为0. 181,比值比为1. 198 (95%可信区间:1. 099～1. 306),P <0. 001。结论 VAT正常的NAFLD已经存在一定程度的IR;腰围是VAT正常的NAFLD的独立危险因素。Objective To investigate the risk factors and insulin resistance (IR) of nonalcoholic fatty liver disease (NAFLD) with a normal visceral adipose tissue (VAT) area. Methods A total of 45 NAFLD persons with a normal VAT area who were admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2017 to May 2018 were enrolled as observation group,and 27 non-NAFLD patients with a normal VAT area were enrolled as control group. VAT area,waist circumference,fasting blood glucose (FBG),and fasting insulin (FINS) were measured for both groups,homeostasis model assessment of insulin resistance (HOMA-IR) was calculated,and the correlation of IR with the indices including waist circumference was analyzed. The independent samples t -test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation of normally and non-normally distributed continuous data. A forward logistic regression analysis was used to identify related risk factors. Results The NAFLD group had a significantly higher level of IR than the control group,and there was a significant difference in HOMA-IR between the two groups (2.66(1.59-4.06) vs 1.84(1.25-2.47),Z=364.000,P =0.005). IR was positively correlated with FBG ( r=0.412,P =0.005),FINS (r=0.789,P <0.001),and TG ( r=0.306,P =0.041). IR was negatively correlated with HDL( r =-9.398,P =0.007). The multivariate regression analysis showed that waist circumference was an independent risk factor for NAFLD with a normal VAT area (regression coefficient = 0.181,odds ratio = 1.198,95% confidence interval: 1.099-1.306,P <0.001). Conclusion There is a certain degree of IR in NAFLD patients with a normal VAT,and waist circumference is an independent risk for NAFLD with a norma

关 键 词：非酒精性脂肪性肝病 腹内脂肪 危险因素 

分 类 号：R575.5[医药卫生—消化系统]