老年非酒精性脂肪性肝病的营养状况及能量代谢特点  

Nutritional status and energy metabolism in elderly patients with nonalcoholic fatty liver disease

作　　者：刘芳[1] 叶青[1] 梁静[1] 曹影影 史利利 赵雪 向慧玲[1] Fang Liu;Qing Ye;Jing Liang;Ying-Ying Cao;Li-Li Shi;Xue Zhao;Hui-Ling Xiang(Tianjin Third Central Hospital,Tianjin Institute of Hepatobiliary Disease,Artificial Cell Engineering Technology Research Center,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院,天津市肝胆疾病研究所,天津市人工细胞工程技术研究中心,天津市300170

出　　处：《世界华人消化杂志》2021年第9期467-473,共7页World Chinese Journal of Digestology

基　　金：天津重大疾病防治科技重大专项项目,No.19ZXDBSY00030.

摘　　要：背景随着全球人口老龄化和非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)增长,老年NAFLD人群特点的研究尤为重要.目的观察老年NAFLD患者的营养状态和能量代谢特点.方法回顾性分析2017-01/2019-01天津市第三中心医院消化科就诊的NAFLD老年患者118例,进行人体成分分析仪分析及应用代谢车评估营养及能量代谢指标,与老年非脂肪肝组进行比较.统计分析中正态分布计量资料采用独立样本t检验,非正态分布计量资料采用Mann-Whitney U检验,二元Logistic回归分析老年NAFLD发生的危险因素.结果人体成分分析显示老年NAFLD组腰臀脂肪比、体脂肪含量较老年非脂肪肝组明显增加(腰臀脂肪比0.95 vs 0.92,体脂肪27.20 kg vs 19.60 kg,P<0.005);代谢车测定结果显示老年NAFLD组静息能量消耗均高于老年非脂肪肝组(1769.00 kcal/d vs 1323.00 kcal/d,P<0.05);进一步比较老年NAFLD患者轻度脂肪肝组与中重度脂肪肝组,轻度脂肪肝组体脂肪、腰臀脂肪比、基础代谢、静息能量消耗明显低于中重度脂肪肝患者.结论在老年NAFLD患者中存在营养失衡和能量代谢紊乱,随脂肪肝程度加重更为显著,通过人体成分分析仪和代谢车以综合评价和监测老年NAFLD患者的营养及能量代谢状态,为疾病干预治疗提供依据.BACKGROUND With the aging of global population and the increase in the incidence of NAFLD,the research of elderly NAFLD population is particularly important.AIM To study the nutritional status and energy metabolism in elderly patients with nonalcoholic fatty liver disease(NAFLD)to provide evidence for disease evaluation,clinical monitoring,and treatment intervention.METHODS One hundred and eighteen elderly patients(≥60 years)with NAFLD were enrolled at Department of Gastroenterology Tianjin Third Central Hospital from January 2017 to January 2019.A non-NAFLD group consisting of non-NAFLD volunteers≥60 years was also included.Nutritional status and energy metabolism were evaluated with a body composition analyzer and metabolic cart(anthropometric measurement,clinical biochemical examination,etc.).RESULTS Body composition analysis showed that the waist-to-hip fat ratio and body fat content of the NAFLD group were significantly higher(waist-to-hip fat ratio 0.95 vs 0.92,body fat 27.20 vs 19.60 kg,P<0.05)compared with those of the non-NAFLD group.The results of metabolic vehicle showed that the resting energy expenditure(REE)of the NAFLD group was increased(1769.00 vs 1706.00 vs 1323.00).In elderly NAFLD patients,body fat,waist-to-hip fat ratio,basal metabolism,and REE in the mild fatty liver group were significantly lower than those in the moderate-severe fatty liver group.CONCLUSION In elderly patients with NAFLD,there are nutritional imbalance and energy metabolism disorder.The nutritional status and energy metabolism of elderly NAFLD patients can be comprehensively evaluated and monitored with a body composition analyzer and metabolic vehicle,so as to provide evidence for disease intervention.

关 键 词：非酒精性脂肪性肝病 老年 生物电阻抗分析 静息能量消耗 营养及能量代谢 

分 类 号：R575.5[医药卫生—消化系统]