尿液pH值和非酒精性脂肪性肝病的相关性研究  

Association between urinary pH value and non-alcoholic fatty liver disease

作　　者：石云 方云芬 代华杰 陈晓鸥 谭利民 汤明明 唐志军 朱雯 邓婵娟 禤立平 王天歌[3] 徐敏[3] 毕宇芳[3] 王卫庆[3] 张寅飞 SHI Yun;FANG Yunfen;DAI Huajie;CHEN Xiaoou;TAN Limin;TANG Mingming;TANG Zhijun;ZHU Wen;DENG Chanjuan;XUAN Liping;WANG Tiange;XU Min;BI Yufang;WANG Weiqing;ZHANG Yinfei(Jiading Town Street Community Healthcare Center,Jiading District,Shanghai 201800,China;Shanghai Health Committee of Jiading District,Shanghai 201821,China;Department of Endocrine and Metabolic Diseases,Ruijin Hospital,National Clinical Research Center for Metabolic Diseases,Shanghai Institute of Endocrine and Metabolic Diseases,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Jiading District Central Hospital,Shanghai University of Medicine&Health Sciences,Shanghai 201800,China)

机构地区：[1]嘉定区嘉定镇街道社区卫生服务中心,上海201800 [2]上海市嘉定区卫生健康委员会,上海201821 [3]上海交通大学医学院附属瑞金医院内分泌代谢病科,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200025 [4]上海健康医学院附属嘉定区中心医院,上海201800

出　　处：《内科理论与实践》2019年第6期337-341,共5页Journal of Internal Medicine Concepts & Practice

基　　金：上海市级医院适宜技术联合开发推广应用项目(项目编号:SHDC12016202)。

摘　　要：目的:研究中老年人群尿液pH值和非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的相关性。方法:采取整群抽样的方法对上海市嘉定社区8292名40岁以上的常住居民进行问卷调查、体格检查、生化检测和高分辨率超声检查。NAFLD的诊断依据高分辨率超声扫描结果。尿液pH值≤5.5定义为低尿液pH值。采用Cochran-Armitage检验分析不同尿液pH值分组间NAFLD患病率的变化趋势。采用Logistic回归分析低尿液pH值与NAFLD的相对危险度。结果:与正常人群相比,NAFLD患者的体质量指数(body mass index,BMI)、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting blood glucose,FPG)、空腹胰岛素、胰岛素抵抗指数、丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,GGT)、高血压患病率、低尿液pH值比例显著升高,而高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)则显著降低(均P<0.01)。随着尿液pH的升高,NAFLD的患病率逐渐下降(趋势P<0.01)。Logistic回归分析表明,与尿液pH值正常人群相比,低尿液pH值者NAFLD的患病风险在男女2组内分别增加了26.3%[优势比(odds ratio,OR)=1.263,95%可信区间(confidence interval,CI):1.002~1.593]和21.8%(OR=1.218,95%CI:1.046~1.417)(P<0.05)。结论:在中老年人群中,低尿液pH值与NAFLD的患病风险呈显著相关性。Objective To study the correlation between urinary pH value and non-alcoholic fatty liver disease(NAFLD)in middle-aged and elderly people.Methods A questionnaire survey,physical examination,biochemical tests and high-resolution ultrasonography were performed on 8292 subjects over 40 years old in Jiading community of Shanghai.NAFLD was diagnosed by high-resolution hepatic ultrasonography.Urinary pH value≤5.5 was defined as low urinary pH value.The Cochran-Armitage test was used to analyze the trend of the prevalence of NAFLD among individuals with different urinary pH value.Logistic regression was performed to explore the effect of low urinary pH value on the risk of NAFLD.Results Except for high-density lipoprotein cholesterol,individuals with NAFLD had higher body mass index systolic blood pressure,diastolic blood pressure,total cholesterol,low-density lipoprotein cholesterol,fasting blood glucose,fasting insulin,insulin resistance index,alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transpeptidase,hypertension prevalence and low urinary pH value ratio than those without NAFLD(P<0.01).The prevalence of NAFLD decreased along with increment of urinary pH value accordingly(P<0.01).Logistic regression analysis demonstrated that low urinary pH value was associated with an increased risk of NAFLD.Compared to subjects with normal urinary pH value,the odds ratio(OR)[95%confidence interval(CI)]of subjects with low urinary pH value for NAFLD was 1.263(1.002-1.593)in men and 1.218(1.046-1.417)in women respectively.Conclusions In the middle-aged and elderly population,low urinary pH value is significantly associated with an increased risk of NAFLD.

关 键 词：尿液pH值 非酒精性脂肪性肝病 中老年人群 

分 类 号：R575.1[医药卫生—消化系统]