金昌队列人群HBV感染状况对脂肪肝患病的影响  

Effect of HBV infection pattern on prevalence of fatty liver disease in Jinchang cohort

作　　者：张文玲 白亚娜[1] 张德生 赵燕红[1] 尹春 霍艳蓓 丁皎 把玉佩 李娜 甘婷 王玉峰 程宁[3] Zhang Wenling;Bai Yana;Zhang Desheng;Zhao Yanhong;Yin Chun;Huo Yanbei;Ding Jiao;Ba Yupei;Li Na;Gan Ting;Wang Yufeng;Cheng Ning(Institute of Epidemiology and Health Statistics,School of Public Health,Lanzhou University,Lanzhou 730000,China;Worker's Hospital of Jinchuan Group,Jinchang 737100,China;School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学公共卫生学院流行病与卫生统计学研究所,730000 [2]金川集团职工医院,金昌737100 [3]兰州大学基础医学院,730000

出　　处：《中华流行病学杂志》2021年第3期488-492,共5页Chinese Journal of Epidemiology

基　　金：兰州大学“一带一路”专项(2018ldbrzd008);国家传染病重大专项《甘肃肝癌高危人群队列的随访研究》(2018ZX10732202)。

摘　　要：目的探讨金昌队列人群HBV感染对脂肪肝患病的影响,为脂肪肝的防治提供理论依据。方法以金昌队列基线人群为研究对象,开展流行病学调查、实验室检查和腹部B超检查,描述并比较不同HBV感染模式下的脂肪肝患病率异同,采用logistic回归分析不同HBV感染模式对脂肪肝患病的影响。结果金昌队列基线人群共45605人,男性27917人,女性17688人,男女性比例1.6∶1;总人群年龄均值为46.49岁。队列人群常见8种HBV感染模式中以大三阳(HBsAg、HBeAg和HBcAb阳性)、小二阳(HBsAg和HBcAb阳性)和小三阳(HBsAg、HBeAb和HBcAb阳性)3种模式的脂肪肝患病率较低。HBsAg和HBeAg阳性组脂肪肝患病率低于HBsAg和HBeAg阴性组。logistic回归分析结果显示,小二阳(OR=0.61,95%CI:0.39~0.98)和大三阳(OR=0.52,95%CI:0.30~0.89)是脂肪肝患病的保护因素。结论急性HBV感染可降低脂肪肝的患病率,原因可能与活跃的HBV复制干扰机体脂肪代谢有关。Objective To investigate the influence of HBV infection on the prevalence of fatty liver disease in Jinchang cohort and provide theoretical evidence for the prevention and treatment of fatty liver disease.Methods Epidemiological investigation,laboratory examination and abdominal ultrasound were conducted in the baseline population of Jinchang cohort to collect the basic data,the differences in the prevalence of fatty liver disease under different HBV infection patterns were described and compared and the influence of different HBV infection patterns on the prevalence of fatty liver disease were evaluated by using logistic regression analysis.Results The baseline Jinchang cohort population totaled 45605,including 27917 males and 17688 females.The male to female ratio was 1.6∶1.The mean age of the overall population was 46.49 years.Among the 8 common HBV infection modes in the Jinchang cohort,the prevalence of fatty liver was low in HBsAg,HBeAg and HBcAb positive,HBsAg and HBcAb positive,and HBsAg,HBeAb and HBcAb positive groups.For 4 serum markers of HBV infection,the prevalence of fatty liver disease in HBsAg and HBeAg positive groups was lower than that in HBsAg and HBeAg negative groups.Logistic regression analysis showed that being HBsAg and HBcAb positive(OR=0.61,95%CI:0.39-0.98)and HBsAg,HBeAg and HBcAb positive(OR=0.52,95%CI:0.30-0.89)could reduce the risk for fatty liver disease.Conclusion Acute HBV infection reduces the prevalence of fatty liver disease,and the reason may be related to the disturbance of the body's fat metabolism by active HBV replication.

关 键 词：脂肪肝 乙型肝炎病毒 金昌队列 

分 类 号：R575.5[医药卫生—消化系统] R512.62[医药卫生—内科学]