肌减少性肥胖与非酒精性脂肪肝的关系  

Relationship between sarcopenic obesity and non-alcoholic fatty liver disease

作　　者：王子兵 宋桂花[1] 王云玲 王然[1] 贺胜文 WANG Zi-bing;SONG Gui-hua;WANG Yun-ling;WANG Ran;HE Sheng-wen(Department of Nutrition,Weifang People's Hospital,Weifang,Shandong Province 261041,China;不详)

机构地区：[1]潍坊市人民医院营养科,山东省潍坊261041 [2]潍坊医学院公共卫生学院

出　　处：《中国慢性病预防与控制》2019年第11期814-817,共4页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：潍坊市科技发展计划项目(2017YX043);山东省自然科学基金资助课题(ZR2010HL058)

摘　　要：目的探讨肌减少性肥胖与非酒精性脂肪肝(NAFLD)的关系,为NAFLD的防治提供理论依据。方法选取2017年7月至2018年7月在潍坊市人民医院体检中心体检并自愿接受体成分分析检测的1 787名≥18岁体检者为研究对象。根据是否为肌减少症和肥胖将研究对象分为正常组(861人)、肌减少症组(101人)、肌减少性肥胖组(303人)和肥胖组(522人),进行问卷调查、体格测量、体成分分析检测、生化指标测定及肝脏B超检查。采用SPSS 18.0软件进行方差分析、Bonferroni法两两比较、χ^2检验和多因素logistic回归分析。结果不同性别的4组人群各重要人体体成分指标差异均有统计学意义(P<0.01);无论男性女性,肌减少性肥胖组内脏脂肪面积、体脂肪量、体脂百分比、腰臀比和体质指数高于其他组,而肌肉量、四肢骨骼肌质量和骨骼肌指数均低于肥胖组,差异均有统计学意义(P<0.008 3)。本研究共检出NAFLD患者554例(31.0%),其中肌减少性肥胖组NAFLD检出率为56.1%。多因素logistic回归结果显示,调整性别、年龄、糖尿病、高脂血症、高血压混杂因素后,相对于正常组,肌减少性肥胖、肌减少症和肥胖与NAFLD高风险相关,均有统计学意义(P<0.05,P<0.01),OR值分别为5.833(95%CI:4.254~7.998)、1.839(95%CI:1.078~3.137)和3.388(95%CI:2.580~4.448)。结论肌减少性肥胖与NAFLD存在相关性,应积极防治肌减少性肥胖,预防NAFLD的发生。Objective To explore the relationship between sarcopenic obesity and non-alcoholic fatty liver disease(NAFLD),and to provide the scientific basis for the prevention and treatment of NAFLD. Methods From July of 2017 to July of 2018,1 787 adult residents (≥18 years old) with physical examination and voluntary body composition analysis in Weifang People’s Hospital were selected as the subjects. The subjects were divided into normal group(861 cases),sarcopenia group(101 cases),sarcopenic obesity group(303 cases) and obesity group(522 cases) according to sarcopenia or obesity. The investigation was performed with the questionnaire,physical measurement,body composition analysis,biochemical test and liver B-ultrasound examination. The ANOVA,Bonferroni method,χ^2 test and multivariate logistic regression analysis were used to analyze the data. The used software was SPSS 18.0. Results There were significant differences in important body composition indexes among the four groups(P <0.01). The visceral fat area,body fat mass,percentage of body fat,waist-hip ratio and body mass index(BMI) in sarcopenic obesity group(males and females) were higher than those in other groups;while the muscle mass,appendicular skeletal muscle mass and skeletal muscle index were significantly lower than those in obesity group(P<0.008 3). The number of NAFLD patients were 554 cases(31.0%),the detection rate of NAFLD in sarcopenic obesity group was 56.1%. The multivariate logistic regression analysis showed that after adjusting the confusion factors of gender,age,diabetes,hyperlipidemia and hypertension,the NAFLD risk in the sarcopenic obesity group,sarcopenia group and obesity group was significantly higher than that in the normal group(OR=5.833,95%CI:4.254-7.998;OR=1.839,95%CI:1.078-3.137 and OR=3.388,95%CI:2.580-4.448,respectively),P<0.05 or P <0.01. Conclusion There was a correlation between sarcopenic obesity and NAFLD,the sarcopenic obesity should be decreased to prevent the occurrence of NAFLD.

关 键 词：肌减少性肥胖 肌减少症 肥胖 非酒精性脂肪肝 

分 类 号：R575.5[医药卫生—消化系统]