北京某地区老年人群非酒精性脂肪性肝病的临床特征及影响因素  

Clinical characteristics and influencing factors of non-alcoholic fatty liver disease in the elderly at a district in Beijing

作　　者：尹慧君 李晓利 徐成 田玲 李彬 胡超 王耀辉 王晓晴 邓玲 李炜 YIN Hui-Jun;LI Xiao-Li;XU Cheng;TIAN Ling;LI Bin;HU Chao;WANG Yao-Hui;WANG Xiao-Qing;DENG Ling;LI Wei(Eighth Department of Healthcare,Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Critical Medicine,Eighth Medical Center,Chinese PLA General Hospital,Beijing 100091,China;Physical Examination Center,Eighth Medical Center,Chinese PLA General Hospital,Beijing 100091,China;Outpatient Department,Eighth Medical Center,Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]中国人民解放军总医院第二医学中心保健八科,北京100853 [2]中国人民解放军总医院第八医学中心重症医学科,北京100091 [3]中国人民解放军总医院第八医学中心体检中心,北京100091 [4]中国人民解放军总医院第八医学中心4门诊部,北京100091

出　　处：《中华老年多器官疾病杂志》2022年第9期651-654,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(81300252)。

摘　　要：目的探讨老年人群非酒精性脂肪性肝病(NAFLD)的临床特征及影响因素。方法纳入2021年5月至2021年9月北京市海淀区≥60岁的离退休老年人782例。根据是否患有NAFLD,分为NAFLD组200例及非NAFLD组582例。比较2组患者的基线资料。采用SPSS 25.0统计软件进行数据分析。采用多因素logistic回归分析NAFLD的影响因素。建立多指标联合预测模型,采用受试者工作特征(ROC)曲线评价其对NAFLD的临床预测价值。结果NAFLD患病率为25.58%(200/782)。与非NAFLD组比较,NAFLD组患者体质量指数(BMI)、糖尿病患病率、丙氨酸氨基转氨酶、天门冬氨酸氨基转移酶、甘油三酯(TG)、空腹血糖(FBG)及尿酸水平均显著升高,年龄、慢性阻塞性肺疾病患病率及高密度脂蛋白胆固醇水平均显著降低,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,NAFLD与女性(OR=1.882,95%CI 1.142~3.100;P=0.013),BMI(OR=1.303,95%CI 1.219~1.393;P=0.000),FBG(OR=1.215,95%CI 1.076~1.372;P=0.002),TG(OR=1.738,95%CI 1.401~2.154;P=0.000)呈正相关,与年龄(OR=0.979,95%CI 0.964~0.995;P=0.009)呈负相关。ROC曲线分析显示,年龄、女性、BMI、FBG及TG多指标联合对老年NAFLD有良好的预测价值,曲线下面积为0.782(95%CI 0.751~0.811)。结论老年NAFLD患病率随年龄的增加而下降。老年NAFLD受多种因素影响,女性、肥胖、糖尿病、血脂异常尤其是TG升高,是老年人NAFLD的危险因素。Objective To investigate the clinical characteristics and influencing factors of non-alcoholic fatty liver disease(NAFLD)in the elderly.Methods A total of 782 retired elderly people aged≥60 years in Haidian District of Beijing were included during May and September 2021.According to whether they had NAFLD or not,they were divided into NAFLD(n=200)and non-NAFLD groups(n=582).The baseline data were compared between the 2 groups of patients.SPSS statistics 25.0 was used for data analysis.Multivariate logistic regression analysis was employed to analyze the influencing factors of NAFLD.A multi-index combined prediction model was established,and its clinical predictive value for NAFLD was evaluated by receiver operating characteristic(ROC)curve.Results The prevalence of NAFLD was 25.58%(200/782).Compared with the non-NAFLD group,the NAFLD group had significantly higher body mass index(BMI),larger proportion of diabetes,and higher levels of alanine aminotransferase,aspartate aminotransferase,triglyceride(TG),fasting blood glucose(FBG)and uric acid,and obviously younger age,lower prevalence of chronic obstructive pulmonary disease and lower high-density lipoprotein-cholesterol level(all P<0.05).Multivariate logistic regression analysis showed that NAFLD was positively correlated with female(OR=1.882,95%CI 1.142-3.100;P=0.013),BMI(OR=1.303,95%CI 1.219-1.393;P=0.000),FBG(OR=1.215,95%CI 1.076-1.372;P=0.002),TG(OR=1.738,95%CI 1.401-2.154;P=0.000),and negatively with age(OR=0.979,95%CI 0.964-0.995);P=0.009).ROC curve analysis showed that the combination of age,female,BMI,FBG and TG had a good predictive value for elderly NAFLD,with an area under the curve of 0.782(95%CI 0.751-0.811).Conclusion The prevalence of NAFLD in the elderly is decreased with age.NAFLD in the elderly is affected by many factors.Female,obesity,diabetes and dyslipidemia,especially TG elevation,are the risk factors of NAFLD in the elderly.

关 键 词：老年人 非酒精性脂肪性肝病 危险因素 

分 类 号：R575[医药卫生—消化系统]