不同性别人群非酒精性脂肪性肝病患病现况及影响因素分析  

Analysis of the Prevalence and Influencing Factors of Non-alcoholic Fatty Liver Disease in Different Gender Groups

作　　者：王丽娜 高鹏飞 曹帆 葛莹[1] 颜维 何岱昆[1] WANG Lina;GAO Pengfei;CAO Fan;GE Ying;YAN Wei;HE Daikun(Department of General Practice,Jinshan Hospital of Fudan University,Shanghai 201508,China;Department of Traditional Chinese Medicine,Jinshan Hospital of Fudan University,Shanghai 201508,China;Emergency and Critical Care Center of Jinshan Hospital of Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属金山医院全科医学科,上海市201508 [2]复旦大学附属金山医院中医科,上海市201508 [3]复旦大学附属金山医院急危重病中心,上海市201508

出　　处：《中国全科医学》2023年第33期4143-4151,共9页Chinese General Practice

基　　金：上海市金山区中医专科联盟建设项目(JSKJ-ZBLM-202002)。

摘　　要：背景脂肪肝是生活中的常见病、多发病,非酒精性脂肪性肝病(NAFLD)患病人数逐年增多,对人们的健康产生了重要影响。不同性别人群在生活方式及基础代谢等方面存在不同,可能导致不同的NAFLD患病现况,但目前针对不同性别人群NAFLD患病情况的相关研究较少。目的研究不同性别人群NAFLD的患病现况及其罹患NAFLD的影响因素,为临床防治NAFLD提供参考。方法回顾性选取2020年8月—2021年8月于复旦大学附属金山医院健康体检中心的29271例体检者为研究对象。收集一般资料、体格检查资料、实验室检查指标、合并基础疾病情况、影像学检查结果。根据NAFLD诊断标准,将体检者分为NAFLD组和对照组,分析NAFLD在不同性别人群中的患病现况及特点;采用多因素Logistic回归分析探讨不同性别罹患NAFLD的影响因素,采用受试者工作特征(ROC)曲线评估相关指标对不同性别人群罹患NAFLD的预测价值,并计算ROC曲线下面积(AUC)、灵敏度、特异度。结果29271例体检者中NAFLD患者10524例,总患病率为35.95%;其中男性体检者18322例,男性NAFLD患者7854例,患病率为42.87%;女性体检者10949例,女性NAFLD患者2670例,患病率为24.39%。不同性别体检者的NAFLD患病率比较,差异有统计学意义(χ^(2)=1016.505,P<0.001)。多因素Logistic回归分析显示,不同性别人群的腰围、BMI、年龄、丙氨酸氨基转移酶、尿酸、三酰甘油、总胆固醇、空腹血糖及心电图结果均是体检者罹患NAFLD的影响因素(P<0.05)。腰围、BMI及腰围与BMI联合诊断不同性别人群罹患NAFLD的预测价值较高,其中腰围预测男性体检者NAFLD患病风险的灵敏度为0.778,特异度为0.613,最佳截断值为85.5 cm;BMI预测男性体检者NAFLD患病风险的灵敏度为0.720,特异度为0.711,最佳截断值为24.6 kg/m^(2);腰围与BMI联合预测时的AUC为0.789,灵敏度为0.744,特异度为0.692,最佳截断值为0.394。腰围预测女�Background Fatty liver disease is a common frequently-occurring disease in daily life,and the number of non-alcoholic fatty liver disease(NAFLD)patients has been gradually increasing in recent years with an important impact on people's health.The differences in lifestyle and basal metabolism in different gender groups may lead to differences in the prevalence of NAFLD.However,few studies have been conducted to investigate the prevalence of NAFLD in different gender populations.Objective To explore the prevalence and influencing factors of NAFLD in different gender groups,so as to provide reference for the prevention and treatment of NAFLD.Methods A total of 29271 subjects received physical examination in the Physical Examination Center of Jinshan Hospital of Fudan University were selected in the retrospective case-control study from August 2020 to August 2021.General data,physical examination data,laboratory indexes,combination of underlying diseases,and imaging findings of the subjects were collected.The included subjects were divided into the NAFLD group and control group according to the diagnostic criteria of NAFLD,and the prevalence and characteristics of NAFLD in different gender groups were analyzed.Multivariate Logistic regression analysis was used to explore the influencing factors of NAFLD by gender;the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of related indicators for NAFLD in different gender groups,and the area under the ROC curve(AUC),sensitivity and specificity were calculated.Results There were 10524 cases of NAFLD among 29271 subjects with an overall prevalence of 35.95%,including 7854 NAFLD patients in the 18322 male subjects with a prevalence of 42.87%,2670 NAFLD patients in the 10949 male subjects with a prevalence of 24.39%.There was a statistically significant difference in the prevalence of NAFLD among subjects with different genders(χ^(2)=1016.505,P<0.001).Multivariate Logistic regression analysis showed that waist circumference,BMI,age,alanine

关 键 词：非酒精性脂肪性肝病 患病率 性别因素 影响因素分析 体格检查 

分 类 号：R575.5[医药卫生—消化系统]