HBV感染人群中运动与非酒精性脂肪性肝病的关联性分析  

Association between physical exercise and non-alcoholic fatty liver disease in people infected with hepatitis B virus

作　　者：蔡欢乐 杜志成 王莹[1] 朱淑明[1] 李菁华 张王剑[1] 顾菁[1] 郝元涛[1,2] Cai Huanle;Du Zhicheng;Wang Ying;Zhu Shuming;Li Jinghua;Zhang Wangjian;Gu Jing;Hao Yuantao(Department of Medical Statistics,School of Public Health,Global Health Institute,Center for Health Information Research,Sun Yat-sen University,Guangzhou 510080,China;Peking University Center for Public Health and Epidemic Preparedness&Response,Beijing 100191,China)

机构地区：[1]中山大学公共卫生学院医学统计学系/中山大学全球卫生研究中心/中山大学卫生信息研究中心,广州510080 [2]北京大学公众健康与重大疫情策略防控战略研究中心,北京100191

出　　处：《中华流行病学杂志》2023年第3期445-451,共7页Chinese Journal of Epidemiology

基　　金：国家科技重大专项(2018ZX10715004)。

摘　　要：目的分析HBV感染人群中运动与非酒精性脂肪性肝病(NAFLD)患病的关联。方法基于2016-2020年国家科技重大专项课题招募的3813例HBV感染者,收集研究对象的患病情况、运动情况及其他协变量信息。采用logistic回归探讨运动与该人群NAFLD患病的关联,并进行亚组分析探讨效应修饰因子。结果共2259例HBV感染者,患有NAFLD者454例(20.10%)。校正协变量后,发现中强度运动为NAFLD的保护因素(OR=0.66,95%CI:0.46~0.94)。亚组分析结果显示,可能在女性(OR=0.61,95%CI:0.36~1.01)、年龄<45岁(OR=0.24,95%CI:0.06~0.80)、小学及以下文化程度(OR=0.16,95%CI:0.04~0.49)、家庭年收入<3万元(OR=0.39,95%CI:0.16~0.89)、3万~8万元(OR=0.64,95%CI:0.40~1.00)、有高血压病史(OR=0.45,95%CI:0.21~0.88)、BMI≥24.0 kg/m^(2)(OR=0.66,95%CI:0.43~1.01)、每日蔬果摄入量较多(OR=0.61,95%CI:0.38~0.97)、每日肉类摄入量较多(OR=0.49,95%CI:0.23~0.97)、不吸烟(OR=0.66,95%CI:0.45~0.95)和无二手烟暴露史(OR=0.61,95%CI:0.37~0.97)的人群中,中强度运动对NAFLD的保护效应更强。结论中强度运动在HBV感染者中与NAFLD存在关联,具有保护效应。女性、低龄、较低文化程度、较低家庭年收入、有高血压病史、BMI偏高、每日蔬果与肉类摄入量较多、不吸烟和无二手烟暴露史的人群可能对该保护效应更敏感。Objective To investigate the association between physical exercise and non-alcoholic fatty liver disease(NAFLD)in people infected with HBV.Methods The information about the 3813 participants infected with HBV,including the prevalence of NAFLD,prevalence of physical exercise and other covariates,were collected from the National Science and Technology Major Project of China during 2016-2020.The logistic regression model was used to evaluate the association between physical exercise and NAFLD in HBV infected patients,and subgroup analysis was performed to identify the effect modifiers.Results A total of 2259 HBV infected participants were included in the final analysis and 454(20.10%)had NAFLD.After adjusting for covariates,we found that moderate physical exercise was a protective factor for NAFLD(OR=0.66,95%CI:0.46-0.94).Subgroup analysis suggested that the protective effect of moderate physical exercise on NAFLD might be stronger in women(OR=0.61,95%CI:0.36-1.01),those<45 years old(OR=0.24,95%CI:0.06-0.80),those who had low education level(OR=0.16,95%CI:0.04-0.49),those who had low annual income(OR=0.39,95%CI:0.16-0.89 for<30000 yuan RMB;OR=0.64,95%CI:0.40-1.00 for 30000-80000 yuan RMB),those who had hypertension(OR=0.45,95%CI:0.21-0.88),those with BMI≥24.0 kg/m2(OR=0.66,95%CI:0.43-1.01),those who had more daily fruit or vegetable intake(OR=0.61,95%CI:0.38-0.97),those who had more daily meat intake(OR=0.49,95%CI:0.23-0.97),and those who had no smoking history(OR=0.66,95%CI:0.45-0.95)or passive smoking exposure(OR=0.61,95%CI:0.37-0.97).Conclusions Among HBV infected patients,moderate physical exercise was negatively associated with the prevalence of NAFLD.Women,young people,those who had low education level,those who had low annual income,those with hypertension,those with high BMI,those who had more daily fruit or vegetable and meat intakes,and those who had no smoking history or passive smoking exposure might be more sensitive to the protective effect.

关 键 词：非酒精性脂肪性肝病 运动 乙型肝炎病毒 

分 类 号：R575[医药卫生—消化系统] R512.62[医药卫生—内科学]