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非肥胖人群非酒精性脂肪性肝病代谢特征及危险因素分析
Metabolic characteristics of nonalcoholic fatty liver disease and related risk factors in non-obese population
文章发布日期:2020年06月01日  来源:  作者:田甜,胡文炜,李雪, 等  点击次数:186次  下载次数:54次

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【摘要】:目的 分析非肥胖人群非酒精性脂肪性肝病(NAFLD)代谢特征及危险因素。 方法 回顾性分析2013年7月-2019年4月在解放军火箭军特色医学中心体检中心接受健康体检人群12 125例。根据BMI分为非肥胖人群(BMI<25 kg/m2)8528例及肥胖人群(BMI≥25 kg/m2)3597例,再根据腹部彩超结果将非肥胖人群分为NAFLD组(n=1025)与非NAFLD组(n=7503)。所有NAFLD人群(n=3281)根据BMI纳入非肥胖-NAFLD亚组(n=1025)、肥胖-NAFLD亚组(n=2256)。收集资料包括性别、年龄、BMI、空腹血糖、尿酸、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血红蛋白水平。非正态分布的计量资料以M(P25~P75)表示,组间比较采用Mann-Whitney U检验。计数资料采用χ2检验。危险因素分析采用多因素logistic回归分析。结果 12 125例体检人群中,NAFLD检出率为27.06%,非肥胖性NAFLD检出率为8.45%,占非肥胖人群的12.02%,在单因素分析的基础上进行多因素logistic回归分析,模型诊断符合率为89%,结果显示年龄增长、BMI、空腹血糖、尿酸、甘油三酯、低密度脂蛋白、血红蛋白为影响非肥胖性NAFLD的独立危险因素(比值比分别为1.043、1.716、1.161、1.004、1.791、2.587、1.011,P值分别为<0.001、<0.001、0.001、<0.001、<0.001、<0.001、0.011),非肥胖患NAFLD与低密度脂蛋白水平关联强度最高;与年龄、尿酸、血红蛋白无关联;总胆固醇、高密度脂蛋白为非肥胖性NAFLD的非易患因素(比值比分别0.521、0.523,P值分别0.007、0.024)。 结论 非肥胖NAFLD与代谢紊乱密切相关,血胆固醇与非肥胖NAFLD的关系尚需进一步研究。
【Abstract】:Objective To investigate the metabolic characteristics of nonalcoholic fatty liver disease (NAFLD) and related risk factors in non-obese population. Methods A retrospective analysis were performed for 12 125 individuals who underwent physical examination in Physical Examination Center of PLA Rocket Force Characteristic Medical Center from July 2013 to April 2019. According to body mass index (BMI) <25 kg/m2, these individuals were divided into non-obese group with 8528 individuals and obese group with 3597 individuals; according to the results of abdominal ultrasound, the non-obese group was further divided into NAFLD group with 1025 individuals and non-NAFLD group with 7503 individuals. According to BMI <25 kg/m2, 3281 individuals with NAFLD were divided into non-obese NAFLD subgroup with 1025 individuals and obese NAFLD group with 2256 individuals. Related clinical data were collected, including sex, age, BMI, fasting blood glucose, uric acid, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, and hemoglobin. Non-normally distributed continuous data were expressed as M(P25-P75), and the Mann-Whitney U test was used for comparison between groups; the chi-square test was used for comparison of categorical data between groups. A multivariate logistic regression analysis was performed to investigate risk factors. Results Among the 12 125 individuals who underwent the physical examination, the detection rate of NAFLD was 27.06%, and the detection rate of non-obese NAFLD was 8.45%, accounting for 12.02% of the non-obese population. The multivariate logistic regression analysis, based on the univariate analysis, had a diagnostic accordance rate of 89%, and the results showed that the increase in age, BMI, fasting blood glucose, uric acid, triglyceride, low-density lipoprotein, and hemoglobin were independent risk factors for non-obese NAFLD (odds ratio [OR]=1.043, 1.716, 1.161, 1.004, 1.791, 2.587, and 1.011, P<0.001, <0.001, =0.001, <0.001, <0.001, <0.001, and =0.011), suggesting that non-obese NAFLD had the strongest association with low-density lipoprotein and had no association with age, uric acid, and hemoglobin. Total cholesterol and high-density lipoprotein were non-susceptible factors for non-obese NAFLD (OR=0.521 and 0.523, P=0.007 and 0.024). Conclusion Non-obese NAFLD is closely associated with metabolic disorders, and further studies are needed to explore the association between serum cholesterol and non-obese NAFLD.
【关键字】:肥胖,腹部; 非酒精性脂肪性肝病; 代谢综合征X; 危险因素
【Key words】:obesity,abdominal; non-alcoholic fatty liver disease; metabolic syndrome X; risk factors
【引证本文】:TIAN T, HU WW, LI X, et al. Metabolic characteristics of nonalcoholic fatty liver disease and related risk factors in non-obese population[J]. J Clin Hepatol, 2020, 36(6): 1310-1313. (in Chinese)
田甜, 胡文炜, 李雪, 等. 非肥胖人群非酒精性脂肪性肝病代谢特征及危险因素分析[J]. 临床肝胆病杂志, 2020, 36(6): 1310-1313.

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