非肥胖型脂肪肝患病率及影响因素分析  

Prevalence rate of non-obese fatty liver disease and related influencing factors

作　　者：邓江 韩致毅[3] 肖彩兰 孙雅亭 吉亚军 敖丽 张永红[4] 鲁晓岚[2,5] DENG Jiang;HAN Zhiyi;XIAO Cailan;SUN Yating;JI Yajun;AO Li;ZHANG Yonghong;LU Xiaolan(Department of Infectious Diseases,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;Department of Gastroenterology,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;a.Department of Gastroenterology,Karamay Central Hospital,Karamay,Xinjiang 834099,China;Physical Examination Center,Karamay Central Hospital,Karamay,Xinjiang 834099,China;Department of Gastroenterology,Pudong Hospital Affiliated to Fudan University,Shanghai 201399,China)

机构地区：[1]西安交通大学第二附属医院感染科,西安710004 [2]西安交通大学第二附属医院消化科,西安710004 [3]克拉玛依市中心医院消化科,新疆克拉玛依834099 [4]克拉玛依市中心医院体检中心,新疆克拉玛依834099 [5]复旦大学附属浦东医院消化科,上海201399

出　　处：《临床肝胆病杂志》2021年第11期2600-2604,共5页Journal of Clinical Hepatology

基　　金：上海市自然基金(20ZR1450100);浦东医院人才课题基金(YJRCJJ201801);中央高校基本科研业务费专项资金资助(xjh012019063);国家十三五重点研发计划课题资助(2018YFC1311504)。

摘　　要：目的分析非肥胖型脂肪肝的患病率及影响因素,为其防治提供参考依据。方法筛选克拉玛依市中心医院2015年1月—12月腹部超声、BMI、年龄及性别资料完整的体检者23545例,分析脂肪肝患病率,继续筛选TG、空腹血糖及ALT等资料完整的正常BMI体检者7484例进行多因素分析。正态分布的定量资料两组间比较采用t检验,非正态分布的定量资料两组间比较采用Mann-Whitney U检验;计数资料组间比较采用χ2检验。采用多因素logistic回归分析非肥胖型脂肪肝的独立影响因素。结果克拉玛依市中心医院2015年体检者脂肪肝患病率为30.2%(7116/23545)。按BMI分层,消瘦、正常BMI、超重及肥胖体检者脂肪肝的患病率依次升高(P值均<0.05),分别为0.8%(6/706)、9.3%(919/9899)、38.4%(3404/8870)及68.5%(2787/4070);男性脂肪肝患病率均高于女性(P值均<0.05)。在919例非肥胖型脂肪肝患者中,青年、中年及老年占比分别为40.7%(374例)、46.1%(424例)及13.2%(121例)。在BMI正常体检者中,中年及老年体检者脂肪肝患病率无显著差异(14.5%vs 16.8%,P>0.05),但都高于青年(6.0%)体检者(P值均<0.05)。青年及中年男性体检者脂肪肝患病率高于同年龄段女性(χ2值分别为99.40、43.29,P值均<0.001),老年男性体检者脂肪肝患病率则低于同年龄段女性(χ2=9.81,P=0.002)。在BMI正常体检者中,TG不高者脂肪肝患病率为5.0%(311/6273),TG升高者脂肪肝患病率为26.8%(325/1211),两者差异有统计学意义(χ2=624.90,P<0.001)。61.5%的非肥胖型脂肪肝患者合并糖脂代谢紊乱。logistic回归分析显示,年龄、BMI、ALT、空腹血糖、TG及血尿酸水平是正常BMI体检者发生非肥胖型脂肪肝的独立影响因素(P值均<0.001)。结论克拉玛依市中心医院体检者中,非肥胖型脂肪肝患病率较高。血清TG水平或可作为非肥胖型脂肪肝简易且有效的筛查指标。Objective To investigate the prevalence rate of non-obese fatty liver disease and its influencing factors,and to provide a reference for the prevention and treatment of fatty liver disease.Methods A total of 23545 individuals who underwent physical examination in Karamay Central Hospital from January to December 2015 and had complete data of abdominal ultrasound,body mass index(BMI),age,and sex were screened out to analyze the prevalence rate of fatty liver disease,and 7484 individuals with normal BMI who had complete data of triglyceride(TG),fasting blood glucose,and alanine aminotransferase(ALT)were further screened out to perform a multivariate analysis.The t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between groups.A multivariate logistic regression analysis was performed to investigate independent influencing factors for non-obese fatty liver disease.Results In 2015,the prevalence rate of fatty liver disease was 30.2%(7116/23545)among the individuals who underwent physical examination in Karamay Central Hospital.A stratified analysis based on BMI showed that the individuals with emaciation,normal BMI,overweight,and obesity had a prevalence rate of 0.8%(6/706),9.3%(919/9899),38.4%(3404/8870),and 68.5%(2787/4070),respectively(all P<0.05),and male individuals had a significantly higher prevalence rate of fatty liver disease than female individuals(all P<0.05).Among the 919 patients with non-obese fatty liver disease,young,middle-aged,and elderly patients accounted for 40.7%(374/919),46.1%(424/919),and 13.2%(121/919),respectively.For the individuals with normal BMI,there was no significant difference in the prevalence rate of fatty liver disease between middle-aged and elderly individuals(14.5%vs 16.8%,P>0.05),while both of them had a significantly higher prevalence rate than the young indivi

关 键 词：脂肪肝 患病率 危险因素 

分 类 号：R575.5[医药卫生—消化系统]