胆囊切除术与代谢相关性脂肪肝的相关性研究  

Correlation analysis between cholecystectomy and Metabolic-associated fatty liver disease

作　　者：田高鹏 甄东户[2] 马言 孙婷 谢晶晶 石兴文 TIAN Gao-peng;ZHEN Dong-hu;MA Yan;SUN Ting;XIE Jing-jing;SHI Xing-wen(The First Clinical School of Lanzhou University;Endocrinology Department of The First Hospital of Lanzhou University)

机构地区：[1]兰州大学第一临床医学院 [2]兰州大学第一医院内分泌科

出　　处：《现代消化及介入诊疗》2023年第6期697-703,共7页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：上海市医药卫生发展基金会糖尿病临床研究项目(I期10研究);甘肃省自然科学基金(21JR1RA096);上海市医药卫生发展基金会国家标准化代谢性疾病管理中心专项研究基金(2018-mmczxjj-3);甘肃省内分泌疾病临床医学研究中心(20JR10FA667);医学院校硕士研究生学位论文质量提升策略研究(lzuyxcx-2022-112)。

摘　　要：目的探讨胆囊切除术与代谢相关性脂肪肝的相关性。方法选取2017年2月至2021年3月接受兰州大学第一医院(Metabolic Management Center,MMC)管理的3998(男2658人,女1340人)例T2DM患者作为研究对象。根据有无胆囊切除术史将人群分为胆囊切除术组(n=657)和非胆囊切除术组(n=3341),比较两组之间MAFLD患病率、一般临床资料、血糖、肝功和血脂等指标的差异,采用二分类Logistic回归模型探讨胆囊切除术与MAFLD的关系。结果(1)胆囊切除术组MAFLD患病率高(61.6%vs 55.8%P=0.006);(2)T2DM胆囊切除术患病率为16.4%;(3)在调整了与MAFLD相关的可能因素后,经历胆囊切除术T2DM患者发生MAFLD风险增加30.7%[OR=1.307,95%CI(1.051~1.626)P=0.016]。(4)与因胆囊结石行胆囊切除术组相比,其他胆囊疾病所致胆囊切除术的MAFLD患病风险无差异(均P>0.05);在确诊T2DM之前行胆囊切除术或者在确诊T2DM之后行胆囊切除术,MAFLD患病风险无差异(P>0.05);与胆囊切除术病史<7年组相比,胆囊切除病史7~12年、12~18年、≥18年的MAFLD患病风险无差异(均P>0.05)。结论胆囊切除术与MAFLD相关。Objective To investigate the relationship between cholecystectomy and Metabolic-associated fatty liver disease.Methods 3998 T2DM patients(2658 males and 1340 females)who received management from Lanzhou University First Hospital(MMC)from February 2017 to March 2021 were selected as the study subjects.The population was divided into the cholecystectomy group(n=657)and the non cholecystectomy group(n=3341)according to whether there was a history of cholecystectomy.To compare the difference of MAFLD prevalence,general clinical data,blood glucose,liver function and blood fat between the two groups,and to explore the relationship between cholecystectomy and MAFLD by using binary logistic regression analysis.Results The prevalence of MAFLD in the cholecystectomy group was high(61.6%vs 55.8%P=0.006);The prevalence of cholecystectomy in T2DM patients was 16.4%;After adjusting for possible factors related to MAFLD,T2DM patients who had undergone cholecystectomy had an increased risk of MAFLD by 30.7%OR=1.30795%CI(1.051-1.626)P=0.016;Compared with the cholecystectomy group due to gallstones,there was no difference in the risk of MAFLD caused by other gallbladder diseases in cholecystectomy(all P>0.05);When cholecystectomy was performed before T2DM was diagnosed or cholecystectomy was performed after T2DM was diagnosed,there was no difference in the risk of MAFLD(P>0.05);Compared with the group with a history of less than 7 years of cholecystectomy,the risk of MAFLD with a history of 7-12 years,12-18 years,and≥18 years of cholecystectomy had no difference(all P>0.05).Conclusion Cholecystectomy is associated with MAFLD.

关 键 词：胆囊切除术 代谢相关性脂肪肝 2型糖尿病 

分 类 号：R575[医药卫生—消化系统]