常州市大学生代谢相关性脂肪性肝病的流行特点  

Prevalence and characteristics of metabolic-associated fatty liver disease in Changzhou college students

作　　者：孙青[1] 叶春艳[1] 陈清华[1] 朱琰 曹喜霞[1] 赵丹洁[1] 付文育 查晨林 柳龙根[1] 张凡[1] SUN Qing;YE Chun-yan;CHEN Qing-hua;ZHU Yan;CHAO Xi-xia;ZHAO Dan-jie;FU Wen-yu;ZHA Chen-lin(the Third Peoole’s Hospital of Changzhou,Jiangsu 213001,China)

机构地区：[1]常州市第三人民医院脂肪肝中心,213001

出　　处：《肝脏》2021年第12期1396-1400,共5页Chinese Hepatology

基　　金：常州市社会科学技术局基础研究项目(CJ20179055,CJ20200059,CJ20210088)。

摘　　要：目的了解常州市大学生代谢相关性脂肪性肝病(MAFLD)的流行情况和特点。方法采用肝脏受控衰减参数(CAP值)和肝脏超声作为MAFLD的诊断标准,对常州市3所大学的308名在校大学生进行脂肪肝的流行情况调查。比较分析MAFLD组与非MAFLD组在人体成分、血压、肝功能、血糖、血脂、尿酸、胰岛素抵抗指数(HOMA-IR)、血常规、饮食营养风险评分(DST scores)、最大摄氧量(VO_(2)Max)方面的差异。采用二元logistic,回归分析体重指数(BMI)、HOMA-IR、饮食营养风险、心肺适能对MAFLD的影响。结果以CAP值和肝脏超声作为诊断标准,MAFLD的发生率分为31.2%和20.6%。MAFLD组的BMI,收缩压、舒张压、ALT、γ-谷氨酰基转移酶(GGT)、三酰甘油(TG)、低密度脂蛋白(LDL)、HOMA-IR、白细胞计数、红细胞计数、血小板计数均高于非MAFLD组,BMI为26.85(24.8,28.5)kg/m^(2)比20.7(18.9,22.08)kg/m^(2)、收缩压为120(113,128)mmHg比110(100,120)mmHg、舒张压为(76.88±7.60)mmHg比(72.06±8.33)mmHg、ALT为20(10,42)U/L比11(9,14)U/L、GGT为23(17,29)U/L比15(11,18)U/L、TG为0.92(0.69,1.51)U/L比0.71(0.56,0.9)U/L、LDL为(2.79±0.61)mmol/L比(2.41±0.67)mmol/L、HOMA-IR为1.59(1.37,3.05)比1.14(0.81,1.48),白细胞计数为(7.64±1.59)×10^(9)比(6.23±1.28)×10^(9)、红细胞计数为(5.21±0.53)×10^(12)比(4.90±0.49)×10^(12)、血小板计数为(284.00±42.73)×10^(9)比(247.11±48.83)×10^(9)。高密度脂蛋白(HDL)、DST scores、VO_(2)Max均低于非NAFLD组(P<0.05),HDL为(1.21±0.25)mmol/L比(1.45±0.33)mmol/L、DST scores为55.57±12.47比60.94±9.67、VO_(2)Max为37(32.75,42.01)比40.71(37.21,49.17)。BMI≥28 kg/m^(2)、HOMA-IR≥1.5、饮食营养有风险、心肺适能较差分别增加MAFLD的患病风险22.5倍、5.1倍、15.3倍、3.3倍。结论大学生的MAFLD流行率高并伴有代谢综合征相关指标的变化应引起足够重视,应降低饮食营养风险、加强锻炼、控制体质量。Objective We sought to investigate the prevalence and characteristics of MAFLD and the influencing factor on the occurrence of MAFLD in 308 Changzhou college students.Methods We used a cross-sectional study design to investigate the occurrence of MAFLD in 308 college students and to establish the differences in parameters between MAFLD students and non-MAFLD students.Binary logistic regression analysis was used to assess the influence of body mass index(BMI),homeostatic model assessment of insulin resistance(HOMA-IR),cardiopulmonary fitness,and dietary risk on the occurrence of MAFLD.Results Using the controlled attenuation parameters(CAP)of liver and ultrasonic as diagnostic criteria,MAFLD occurred in 31.2%and 20.6%of participants.BMI,systolic blood pressure,diastolic blood pressure,alanine aminotransferase(ALT),gamma-glutamyl transferase(GGT),triglyceride(TG),low-density lipoprotein(LDL),HOMA-IR,white blood cell count(WBC),red blood cell count(RBC),and platelet count(PLT)of MAFLD students were higher than those of non-MAFLD students,BMI was 26.85(24.8-28.5)vs 20.7(18.9-22.08),systolic blood pressure was 120(113-128)vs 110(100-120),diastolic blood pressure was 76.88±7.60 vs 72.06±8.33,ALT was 20(10-42)vs 11(9-14),GGT was 23(17-29)vs 15(11-18),TG was 0.92(0.69-1.51)vs 0.71(0.56-0.9),LDL was(2.79±0.61)vs(2.41±0.67),HOMA-IR was 1.59(1.37-3.05)vs1.14(0.81-1.48),WBC was(7.64±1.59)vs(6.23±1.28),RBC was(5.21±0.53)vs(4.90±0.49),PLT was(284.00±42.73)vs(247.11±48.83).While dietary screening tool(DST)scores,VO_(2)Max,and high-density lipoprotein(HDL)were lower than those of non-MAFLD students(P<0.05),HDL was(1.21±0.25)vs(1.45±0.33),DST score was(55.57±12.47)vs(60.94±9.67),VO_(2)Max was 37(32.75-42.01)vs 40.71(37.21-49.17).BMI≥28,HOMA-IR≥1.5,nutritional in risk and poor cardiopulmonary fitness increased the risk for MAFLD(OR=22.5,5.1,15.3,3.3,P<0.05).Conclusion MAFLD in college students requires attention and early intervention.

关 键 词：代谢相关性脂肪性肝病 脂肪肝 代谢综合征 流行 

分 类 号：R575.5[医药卫生—消化系统]