高密度脂蛋白胆固醇和非酒精性脂肪肝发生的相关性--基于日本人群的一项横断面研究  

Association between high density lipoprotein and nonalcoholic fatty liver disease:a cross-sectional study in Japanese population

作　　者：梁文迪 苏钰琦 胡彪 甘胤文 黄卫超 杨其霖[2] Liang Wendi;Su Yuqi;Hu Biao;Gan Yinwen;Huang Weichao;Yang Qilin(Guangzhou Medical University,Guangzhou 510260,China;Department of critical medicine,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学,广东广州1510260 [2]广州医科大学附属第二医院重症医学科,广东广州2510260

出　　处：《中华临床实验室管理电子杂志》2021年第3期154-159,共6页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

摘　　要：目的探索高密度脂蛋白胆固醇(high-density lipoproteincholesterol,HDL-C)浓度与非酒精性脂肪肝(non-alcoholic fattyliverdisease,NAFLD)发生率两者之间的相关性,为建立脂肪肝(非酒精性)的非创伤性模型提供参考。方法首先运用logistic回归模型评价血清中HDL-C与日本人群NAFLD的关联,然后作平滑曲线拟合图探索HDL-C与NAFLD的发生率中存在的关系,最后使用分段线性回归探索HDL-C和NAFLD的关联拐点。结果该研究纳入人数共有15464例,其中有2741例被诊断为NAFLD。调整性别、年龄、吸烟情况、喝酒习惯、身体质量指数(body massindex,BMI)、总胆固醇(total cholesterol,TC)、丙氨酸转氨酶(alanine transaminase,ALT)、天门冬氨酸转氨酶(aspartate aminotransferase,AST)、谷氨酰转肽酶(γ-glutamyl transpeptadase,GGT)、三酰甘油(triglyceride,TG)、空腹血糖、收缩压、舒张压和糖化血红蛋白(glycated hemoglobin,HbA_(1c))后,以低水平组的参与者为参照系,中、高水平参与者NAFLD发生率降低至低水平参与者NAFLD发生率的85%和47%[OR分别为0.85(0.73,0.98)和0.47(0.38,0.58)]。平滑曲线拟合结果显示:HDL-C≤2.19 mmol/L时,NAFLD发生率随HDL-C升高而降低[HR 0.19(0.15,0.23),P<0.0001];而当HDL-C>2.19 mmol/L时,风险无显著关联[HR 2.24(0.78,6.44),P=0.1358]。结论高水平的HDL-C和NAFLD的发病率有关联关系,脂蛋白胆固醇(高密度)浓度越高,NAFLD发病率越低。当HDL-C>2.19 mmol/L时,相关性不明显。Objective To clarify the association between serum high density lipoprotein cholesterol(HDL-C)and the incidence rate of nonalcoholic fatty liver disease(non-alcoholic fatty liver disease).Methods Logistic regression model was used to evaluate the association between baseline serum HDL-C level and the occurrence of nonalcoholic fatty liver disease(NAFLD)in Japanese population.The dose-dependent relationship between HDL-C and NAFLD was analyzed by smooth curve fitting.The threshold effect of HDL-C and NAFLD was found by piecewise linear regression model.Results A total of 15464 people were enrolled in the study,and 2741 cases were diagnosed as nonalcoholic fatty liver disease.After adjusting for age,gender,smoking status,alcohol intake,BMI,HbA_(1c) and TC,the risk of non-alcoholic fatty liver disease in middle and high-level participants was reduced to 85%and 47%of the incidence of NAFLD in low-level participants[OR=0.85(0.73,0.98)and 0.47(0.38,0.58)].Smooth curve fitting showed that when HDL-C<2.19 mmol/L,the risk of non-alcoholic fatty liver disease decreased with the increase of HDL-C[HR 0.19(0.15,0.23),P<0.0001],but when HDL-C>2.19 mmol/L,the risk was not significantly associated[HR 2.24(0.78,6.44)P=0.1358].Conclusion The incidence rate of HDL-C is correlated with the incidence of nonalcoholic fatty liver disease.The higher the HDL-C level,the lower the incidence rate of non-alcoholic fatty liver disease.When HDL-C>2.19 mmol/L,the correlation was not obvious.

关 键 词：高密度脂蛋白胆固醇 脂肪肝 

分 类 号：R575.5[医药卫生—消化系统]