基于限制性立方样条模型分析绝经时间、绝经年龄与非酒精性脂肪性肝病的关系  

Association of menopausal time and menopausal age with nonalcoholic fatty liver disease:An analysis based on a restricted cubic spline model

作　　者：赵晨露 马素平[1] 尚东方[1] 刘素彤 刘晓彦[1] 郑瑗瑗 赵文霞[1] ZHAO Chenlu;MA Suping;SHANG Dongfang;LIU Sutong;LIU Xiaoyan;ZHENG Yuanyuan;ZHAO Wenxia(Department of Spleen,Stomach,Liver and Gallbladder Diseases,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院脾胃肝胆病科,郑州450000 [2]河南中医药大学第一临床医学院,郑州450000

出　　处：《临床肝胆病杂志》2025年第2期247-253,共7页Journal of Clinical Hepatology

基　　金：第二届全国名中医工作室建设项目(国中医药办人教函[2022]245号);河南省中医学双一流创建科学研究专项(HSRP-DECTCM-2023-3-13);河南省特色骨干学科中医学学科建设项目(STG-ZYXKY-2020024)。

摘　　要：目的探讨绝经时间、绝经年龄与非酒精性脂肪性肝病(NAFLD)发病风险的关系,为临床早期防治NAFLD提供依据。方法收集2017年1月—2021年12月就诊于河南中医药大学第一附属医院脾胃肝胆病科门诊的373例绝经后女性患者的基本信息、绝经年龄、绝经时间及是否患有NAFLD。计数资料组间比较采用χ^(2)检验;符合正态分布的计量资料两组间比较采用成组t检验,不符合正态分布的计量资料两组间比较采用Wilcoxon秩和检验;采用Logistic回归分析绝经时间、年龄与NAFLD风险的关联强度(OR)及95%CI,采用限制性立方样条法(RCS)分析绝经时间、年龄与NAFLD患病风险的剂量反应关系。结果与正常绝经和晚期绝经者相比,早期绝经者的NAFLD患病率、肝脂肪变性和肝纤维化分级程度均较高(P值均<0.05)。调整年龄、初潮年龄等混杂因素后,与绝经时间≤3年相比,绝经时间>3年者NAFLD患病风险为前者的4.80倍(95%CI:1.93~11.95,P=0.001);与正常绝经年龄者相比,早期绝经年龄者和晚期绝经年龄者NAFLD患病风险分别为前者的8.14倍(95%CI:1.77~37.58,P=0.007)和0.09倍(95%CI:0.03~0.32,P<0.001)。绝经时间、绝经年龄与NAFLD患病风险呈现剂量-反应关系,绝经时间与NAFLD患病关联强度呈正相关,而绝经年龄与NAFLD患病关联强度呈负相关。结论绝经时间越长、绝经年龄越早者患NAFLD风险越高。Objective To investigate the association of menopausal time and menopausal age with the risk of nonalcoholic fatty liver disease(NAFLD),and to provide a basis for the early prevention and treatment of NAFLD in clinical practice.Methods Related data were collected from 373 postmenopausal women who attended the outpatient service of Department of Spleen,Stomach,Liver and Gallbladder Diseases,The First Affiliated Hospital of Henan University of Chinese Medicine,from January 2017 to December 2021,including general information,menopausal age,menopausal time,and presence or absence of NAFLD.The chi-square test was used for comparison of categorical data;the independent-samples t test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups.A Logistic regression analysis was used to calculate the association intensity and 95%confidence interval(95%CI)of menopausal time and menopausal age for the risk of NAFLD,and the restricted cubic spline(RCS)method was used to investigate the dose-response relationship between menopausal time/age and the risk of NAFLD.Results Compared with the women with normal menopause or late menopause,the women with early menopause had a higher prevalence rate of NAFLD and a higher degree of steatosis and fibrosis(all P<0.05).After adjustment for the confounding factors such as age and age of menarche,the risk of NAFLD in women with a menopausal time of>3 years was 4.80(95%CI:1.93-11.95,P=0.001)times that in women with a menopausal time of≤3 years,and the risk of NAFLD in women with early or late menopause was 8.14 times(95%CI:1.77-37.58,P=0.007)and 0.09 times(95%CI:0.03-0.32,P<0.001),respectively,that in those with a normal menopausal age.There is a dose-response relationship between menopausal time/age and the risk of NAFLD.Menopausal time is positively correlated with the association intensity of NAFLD,while menopausal age is negatively correlated with the a

关 键 词：非酒精性脂肪性肝病 绝经期 限制性立方样条 

分 类 号：R575.5[医药卫生—消化系统]