中老年人血尿酸水平与非酒精性脂肪性肝病的相关性研究  

Relationship between serum uric acid level and nonalcoholic fatty liver disease in middle-aged and elderly people

作　　者：张艳[1] 梁怡然 黄一沁[3] 吴毓敏[3] 张赣生[3] 陈洁[3] 王姣锋[1] 保志军[1] 

机构地区：[1]复旦大学附属华东医院老年科,上海市200040 [2]复旦大学附属中山医院肾内科,上海市200032 [3]复旦大学附属华东医院消化科,上海市200040

出　　处：《老年医学与保健》2016年第3期-,共4页Geriatrics & Health Care

基　　金：上海市老年医学临床重点实验室(13dz2260700);上海市卫生计生系统重要薄弱学科建设项目-老年医学(2015ZB0501);面上项目(201440550);上海申康医院发展中心(SHDC12012207)

摘　　要：目的 分析中老年人血尿酸(UA)水平与非酒精性脂肪性肝病(NAFLD)的相关性.方法 回顾性调查2015年1月-12月华东医院体检中心体检的中老年人515例.以血尿酸水平四分位数为界点,将人选者分为4组,Q1组(＜308 μmol/L),Q2组(308 ～ 364 μmol/L),Q3组(365 ～420 μmol/L),Q4组(＞420 μmot/L).连续性数据使用独立样本f检验或M-W秩和检验;计数资料的趋势性检验采用卡方检验;危险因素分析采用Binary Logistic回归分析.结果 本人群中NAFLD的检出率为61.17％;高尿酸血症检出率为26.6％.Logistic回归分析显示:高三酰甘油血症、高血压、肥胖、高尿酸血症与NAFLD相关,OR值分别为3.4、1.784、5.681、3.347.Q1、Q2、Q3、Q4组NAFLD的检出率分别为40.9％、52.8％、65.6％、85.9％,NAFLD的检出率随UA水平升高呈上升趋势(趋势检验P＜0.05).单因素Logistic回归结果显示,Q2、Q3、Q4组的NAFLD患病风险均高于Q1组;校正混杂因素后多因素Logistic结果显示,Q3、Q4组的NAFLD患病风险均高于Q1组(P＜0.05).在Q1～Q4组中对代谢综合征各项诊断指标的检出率进行趋势性检验,结果显示,肥胖、高三酰甘油血症、低高密度脂蛋白胆固醇血症、高血压检出率随尿酸水平升高,呈上升趋势(趋势检验P＜0.05).结论 中老年人群血UA水平与NAFLD可能相关,随UA水平升高,NAFLD患病危险性增加.Objective To analyze the relationship between serum uric acid(SUA) levels and nonalcoholic fatty liver disease(NAFLD) in middle-aged and elderly population.Methods 515 middle-aged and elderly patients who participated in the health check-up program from January 2015 to December 2015 were retrospectively assessed to collect the previous disease history.Subgrouping was performed according to SUA quartiles,as follows:Q1 group(<308 μmol/L);Q2group(308~364 μmol/L);Q3 group(365~420 μmol/L);Q4 group(>420 μmol/L).The independent-sample t-test or M-W U test was used to compare contiguous data variables between groups.Categorical variables were examined by the chi-square test.Binary logistic analysis was used to determine the risk factors for fatty liver and to adjust for possible confounders.Results The detection rate of NAFLD patients among this population was 61.17%;while the detection rate of hyperuricemia was 26.6%.Binary logistic regression analysis showed that hypertriglyceridemia,hypertension,obesity,hyperuricemia were correlated factors for NAFLD(OR=3.4,1.784,5.681,3.347,respectively).The detection rate of NAFLD showed a rising trend with the increase of SUA from quartile 1 to quartile 4,as 40.9%,52.8%,65.6%,and 85.9%,respectively(Trend test P<0.05).Binary logistic regression analysis showed that patients in the SUA Q2,Q3 and Q4 had significantly higher risk of NAFLD detection rate than patients in the Q1 group;with adjustment of confounders,patients in the SUA Q3 and Q4 group had significantly higher risk of NAFLD detection rate than patients in the Q1 group(P<0.05).To analyze the detection rate of metabolic syndrome in Q1-Q4 group,trend test showed that detection rate of obesity,high level of TG,low level of HDL,hypertension rose with elevated level of uric acid(Trend test P< 0.05).Conclusion SUA levels may be correlated with NAFLD in middle-aged and elderly population and the prevalence of NAFLD increases with increasing SUA.

关 键 词：中老年 非酒精性脂肪性肝病 血尿酸 危险因素 

分 类 号：R575.5[医药卫生—消化系统]