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非肥胖型脂肪肝患病率及影响因素分析

邓江 韩致毅 肖彩兰 孙雅亭 吉亚军 敖丽 张永红 鲁晓岚

邓江,韩致毅,肖彩兰,等. 非肥胖型脂肪肝患病率及影响因素分析[J]. 临床肝胆病杂志, 2021, 37(11): 2600-2604. DOI: 10.3969/j.issn.1001-5256.2021.11.022
引用本文: 邓江,韩致毅,肖彩兰,等. 非肥胖型脂肪肝患病率及影响因素分析[J]. 临床肝胆病杂志, 2021, 37(11): 2600-2604. DOI: 10.3969/j.issn.1001-5256.2021.11.022
DENG J, HAN ZY, XIAO CL, et al. Prevalence rate of non-obese fatty liver disease and related influencing factors[J]. J Clin Hepatol, 2021, 37(11): 2600-2604. DOI: 10.3969/j.issn.1001-5256.2021.11.022
Citation: DENG J, HAN ZY, XIAO CL, et al. Prevalence rate of non-obese fatty liver disease and related influencing factors[J]. J Clin Hepatol, 2021, 37(11): 2600-2604. DOI: 10.3969/j.issn.1001-5256.2021.11.022

非肥胖型脂肪肝患病率及影响因素分析

DOI: 10.3969/j.issn.1001-5256.2021.11.022
基金项目: 

上海市自然基金 20ZR1450100

浦东医院人才课题基金 YJRCJJ201801

中央高校基本科研业务费专项资金资助 xjh012019063

国家十三五重点研发计划课题资助 2018YFC1311504

详细信息
    通讯作者:

    张永红,813467534@qq.com

    鲁晓岚,xiaolan_lu@163.com

  • 中图分类号: R575.5

Prevalence rate of non-obese fatty liver disease and related influencing factors

Research funding: 

Shanghai Natural Science Foundation of China 20ZR1450100

Talents Training Program of Pudong Hospital affiliated to Fudan University YJRCJJ201801

the Fundamental Research Funds for the Central Universities xjh012019063

National Key Research and Development Program of China during the 13th Five-Year Plan Period 2018YFC1311504

  • 摘要:   目的  分析非肥胖型脂肪肝的患病率及影响因素,为其防治提供参考依据。  方法  筛选克拉玛依市中心医院2015年1月—12月腹部超声、BMI、年龄及性别资料完整的体检者23 545例,分析脂肪肝患病率,继续筛选TG、空腹血糖及ALT等资料完整的正常BMI体检者7484例进行多因素分析。正态分布的定量资料两组间比较采用t检验,非正态分布的定量资料两组间比较采用Mann-Whitney U检验;计数资料组间比较采用χ2检验。采用多因素logistic回归分析非肥胖型脂肪肝的独立影响因素。  结果  克拉玛依市中心医院2015年体检者脂肪肝患病率为30.2% (7116/23 545)。按BMI分层,消瘦、正常BMI、超重及肥胖体检者脂肪肝的患病率依次升高(P值均<0.05),分别为0.8%(6/706)、9.3%(919/9899)、38.4%(3404/8870)及68.5%(2787/4070);男性脂肪肝患病率均高于女性(P值均<0.05)。在919例非肥胖型脂肪肝患者中,青年、中年及老年占比分别为40.7%(374例)、46.1%(424例)及13.2%(121例)。在BMI正常体检者中,中年及老年体检者脂肪肝患病率无显著差异(14.5% vs 16.8%,P>0.05),但都高于青年(6.0%)体检者(P值均<0.05)。青年及中年男性体检者脂肪肝患病率高于同年龄段女性(χ2值分别为99.40、43.29,P值均<0.001),老年男性体检者脂肪肝患病率则低于同年龄段女性(χ2=9.81,P=0.002)。在BMI正常体检者中,TG不高者脂肪肝患病率为5.0%(311/6273),TG升高者脂肪肝患病率为26.8%(325/1211),两者差异有统计学意义(χ2=624.90,P<0. 001)。61.5%的非肥胖型脂肪肝患者合并糖脂代谢紊乱。logistic回归分析显示,年龄、BMI、ALT、空腹血糖、TG及血尿酸水平是正常BMI体检者发生非肥胖型脂肪肝的独立影响因素(P值均<0. 001)。  结论  克拉玛依市中心医院体检者中,非肥胖型脂肪肝患病率较高。血清TG水平或可作为非肥胖型脂肪肝简易且有效的筛查指标。

     

  • 表  1  克拉玛依市中心医院2015年体检者按BMI分层后脂肪肝患病率

    BMI(kg/m2) 总体(%) 男性(%) 女性(%) χ2 P
    <18.5 0.8 (6/706) 2.4(4/170) 0.4 (2/536) 3.88 0.049
    18.5~23.9 9.3 (919/9899) 12.3 (551/4473) 6.8 (368/5426) 89.23 <0.001
    24.0~27.9 38.4 (3404/8870) 40.5 (2580/6367) 32.9 (824/2503) 43.89 <0.001
    ≥28.0 68.5 (2787/4070) 70.2 (2126/3028) 63.4 (661/1042) 16.49 <0.001
    下载: 导出CSV

    表  2  2015年正常BMI体检者按年龄段分层后脂肪肝患病率

    年龄段 总体(%) 男性(%) 女性(%) χ2 P
    青年 6.0 (374/6244) 9.2 (267/2901) 3.2 (107/3343) 99.40 <0.001
    中年 14.5 (424/2934) 20.0 (219/1096) 11.2 (205/1838) 43.29 <0.001
    老年 16.8 (121/721) 13.7 (65/476) 22.3 (56/245) 9.81 0.002
    注:18~44岁为青年,45~59岁为中年,>59岁为老年。
    下载: 导出CSV

    表  3  2015年正常BMI体检者非脂肪肝组及脂肪肝组基线资料比较

    指标 脂肪肝组(n=636) 非脂肪肝组(n=6848) 统计值 P
    男/女(例) 423/213 3098/3750 χ2=105.68 <0.001
    年龄(岁) 44(35~50) 38(28~45) Z=12.70 <0.001
    BMI(kg/m2) 23.0(22.1~23.5) 21.8(20.5~22.9) Z=18.39 <0.001
    空腹血糖(mmol/L) 5.1 (4.7~5.6) 4.9(4.6~5.3) Z=7.96 <0.001
    收缩压(mmHg) 124±16 118±15 t=9.40 <0.001
    ALT(U/L) 24.8(18.0~33.9) 16.0(12. 0~22.8) Z=19.53 <0.001
    总胆红素(μmol/L) 14.0(10.3~17.7) 13.0(9.7~16.7) Z=4.00 <0.001
    TC(mmol/L) 1.9(1.3~2.7) 1.0 (0.8~1.4) Z=24.69 <0.001
    TG(mmol/L) 4.9±1.0 4.5±0.8 t=10.87 <0.001
    血尿酸(μmol/L) 328.7±81.0 280.2±74.2 t=14.53 <0.001
    下载: 导出CSV

    表  4  非肥胖型脂肪肝logistic回归分析

    因素 B P OR 95%CI
    年龄(岁) 0.037 <0.001 1.038 1.027~1.048
    BMI(kg/m2) 0.469 <0.001 1.598 1.472~1.735
    空腹血糖(mmol/L) 0.114 <0.001 1.121 1.053~1.192
    ALT(U/L) 0.013 <0.001 1.013 1.009~1.017
    TG(mmol/L) 0.448 <0.001 1.566 1.440~1.702
    血尿酸(μmol/L) 0.005 <0.001 1.005 1.004~1.006
    性别 0.123 0.297 1.131 0.898~1.425
    收缩压(mmHg) 0.001 0.804 1.001 0.995~1.007
    总胆红素(μmol/L) 0.006 0.366 1.006 0.993~1.020
    TC(mmol/L) 0.081 0.133 1.084 0.976~1.204
    下载: 导出CSV
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  • 收稿日期:  2021-04-05
  • 录用日期:  2021-04-28
  • 出版日期:  2021-11-20
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