不良生活习惯对代谢相关脂肪性肝病肝纤维化进展的影响  

Effects of adverse lifestyle on the progression of liver fibrosis in patients with metabolic associated fatty liver disease

作　　者：王海斌 李晖[1] 陈晓蕾[2] 刘娜[2] 严晓会 邹玉 李春梅[1] 吴长会 陈华仙 刘向 龚明 李全美[2] WANG Haibin;LI Hui;CHEN Xiaolei;LIU Na;YAN Xiaohui;ZOU Yu;LI Chunmei;WU Chan-ghui;CHEN Huaxian;LIU Xiang;GONG Ming;LI Quanmei(Department of Infectious Diseases,the Affiliated Hospital of Yunnan University(the Second People′s Hospital of YunNan Province),Kunming 650000,China;不详)

机构地区：[1]云南大学附属医院(云南省第二人民医院、云南省眼科医院)感染性疾病科,昆明650000 [2]昆明市第一人民医院内分泌科,昆明650000

出　　处：《实用医学杂志》2022年第17期2181-2184,共4页The Journal of Practical Medicine

基　　金：昆明市卫生科技人才“百工程”项目(编号:2020-SE(省)-09)。

摘　　要：目的 探索肥胖、不良生活习惯(不进食早餐、晚睡、点外卖、久坐)对代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)肝纤维化进展的影响。方法 选取2017年7月至2018年7月于云南大学附属医院行FibroTouch的就诊者进行横断面分析,根据FibroTouch所检测受控衰减参数值(controlled attenuation parameter,CAP)将就诊者分为健康对照组(n=1 731)及MAFLD组(n=410),再根据FibroTouch所检测肝硬度值(liver stiffness measurement,LSM)将MAFLD组患者分为无或轻度肝纤维化组(n=262)及进展性肝纤维化组(n=148),运用χ^(2)检验、Spearman相关分析、二分类logistic回归分析不良生活习惯对肝纤维化进展的影响。结果 健康对照组及MAFLD组间性别、LSM、体质量指数(body mass index,BMI)差异均有统计学意义(P <0.05);MAFLD组中年龄、LSM、BMI、CAP间存在明显相关性(P <0.001);无或轻度肝纤维化组及进展性肝纤维化组间年龄、LSM、BMI、CAP、不良生活习惯差异均有统计学意义(P <0.05);二分类logistic回归分析显示,BMI、不良生活习惯是MAFLD肝纤维化进展的独立危险因素(P <0.05)。结论 肥胖、不良生活习惯等危险因素增加了MAFLD患者肝纤维化进展的风险。Objective To explore the influence of obesity and bad living habits on the progression of liver fibrosis in metabolic associated fatty liver disease. Methods Patients undergoing FibroTouch in the Affiliated Hospital of Yunnan University from July 2017 to July 2018 were selected for cross-sectional analysis. According to the controlled attenuation parameters detected by FibroTouch,the patients were divided into healthy control group(n = 1731)and MAFLD group(n = 410),then according to the liver hardness value detected by FibroTouch,MAFLD group was divided into no or mild liver fibrosis group(n = 262)and progressive liver fibrosis group(n = 148). Chi-square test,Spearman correlation analysis and binary Logistic regression were used to analyze the influence of bad living habits on the progression of liver fibrosis. Results Statistically significant differences in gender,LSM and BMI were found between healthy control group and MAFLD group(P < 0.05). There were significant correlations among age,LSM,BMI and CAP in MAFLD group(P < 0.001). There were statistically significant differences in age,LSM,BMI,CAP and bad living habits between the group without or mild liver fibrosis and the group with advanced liver fibrosis(P < 0.05). Binary Logistic regression analysis showed BMI and bad living habits were independent risk factors for progression of liver fibrosis in MAFLD(P < 0.05).Conclusion Risk factors such as obesity and bad living habits increased the risk of liver fibrosis progression in patients with MAFLD.

关 键 词：代谢相关脂肪性肝病 肝纤维化 肝硬度 不良生活习惯 危险因素 

分 类 号：R589.2[医药卫生—内分泌] R575.2[医药卫生—内科学]