老年人群残余胆固醇与代谢相关脂肪性肝病的关联性和剂量反应关系的研究  

Research on the association and dose-response relationship between residual cholesterol and metabolically associated fatty liver disease in the elderly

作　　者：梁宝怡 沈天然 郑秋潼 谢灵香 喻陆 陈青松 LIANG Bao-yi;SHEN Tian-ran;ZHENG Qiu-tong;XIE Ling-xiang;YU Lu;CHEN Qing-song(School of Public Health,Guangdong Pharmaceutical University,Guangzhou,Guangdong 510310,China;不详)

机构地区：[1]广东药科大学公共卫生学院,广东广州510310 [2]广东省公共卫生检测与评估工程技术研究中心,广东广州510000 [3]国药集团国药医疗健康产业有限公司(北京)

出　　处：《现代预防医学》2025年第3期520-525,共6页Modern Preventive Medicine

摘　　要：目的分析中山地区老年人群中残余胆固醇(RC)和代谢相关脂肪性肝病(MAFLD)的关系,探讨RC在老年人MAFLD患病诊断中的潜在的应用价值。方法采用整群抽样法,选取广东省中山市两家社区医院接受健康体检的60岁及以上老年人作为研究对象,通过问卷调查、体格检查和实验室检测收集基线数据。运用多因素logistic回归分析,评估RC与MAFLD之间的关联,利用限制性立方样条模型深入分析RC与MAFLD之间的剂量-反应关系。结果共招募了6756名老年人,MAFLD的总体患病率为31.0%,女性患病率为35.0%,高于男性的24.7%。调整混杂因素后,logistic回归分析表明,RC作为连续变量(OR=1.70,95%CI:1.47~1.97)与MAFLD患病风险呈正相关。作为分类变量,RC最高组(OR=2.13,95%CI:1.72~2.63)与MAFLD患病风险仍呈正相关。RC水平与MAFLD存在非线性关系(P_(总趋势)<0.001,P_(非线性)<0.05),且在男性中这一风险上升更为显著[男性OR=1.83(95%CI:1.42~2.38)vs.女性(OR=1.64,95%CI:1.36~1.96)]。结论RC是老年人患MAFLD的独立危险因素,且二者之间存在非线性剂量-反应关系。RC水平对MAFLD风险的影响在老年男性中更突出。RC的监测和管理在老年人MAFLD的预防和治疗中具有重要的临床意义。Objective To analyze the relationship between residual cholesterol(RC)and metabolically associated fatty liver disease(MAFLD)in the elderly population of Zhongshan,and to explore the potential application value of RC in the diagnosis of MAFLD in older adults.Methods A cluster sampling method was employed to select elderly individuals aged 60 and above who underwent health check-ups at two community hospitals in Zhongshan,Guangdong Province.Baseline data were collected through questionnaire surveys,physical examinations,and laboratory tests.Multivariable logistic regression analysis was used to assess the association between RC and MAFLD,and a restricted cubic spline model was utilized to further analyze the dose-response relationship between RC and MAFLD.Results A total of 6756 elderly individuals were recruited,with an overall prevalence of MAFLD at 31.0%,higher in females(35.0%)than in males(24.7%).After adjusting for confounding factors,logistic regression analysis indicated that RC,treated as a continuous variable(OR:1.70,95%CI:1.47-1.97),was positively associated with the risk of MAFLD.As a categorical variable,the highest RC group(OR:2.13,95%CI:1.72-2.63)also showed a positive correlation with MAFLD risk.A non-linear relationship was observed between RC levels and MAFLD(P_(overall trend)<0.001,P_(non-linearity)<0.05),with a more pronounced risk increase in males(male OR:1.83,95%CI:1.42-2.38 vs.female OR:1.64,95%CI:1.36-1.96).Conclusion RC is an independent risk factor for MAFLD in the elderly,and there exists a non-linear dose-response relationship between the two.The impact of RC levels on MAFLD risk is particularly significant in elderly males.Monitoring and managing RC is of great clinical significance in the prevention and treatment of MAFLD in older adults.

关 键 词：残余胆固醇 代谢相关脂肪性肝病 剂量反应关系 老年人 

分 类 号：R575.5[医药卫生—消化系统]