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腹腔内脂肪面积正常的非酒精性脂肪性肝病的危险因素分析
Risk factors of nonalcoholic fatty liver disease with a normal visceral adipose tissue area
文章发布日期:2019年04月04日  来源:  作者:黄志鹏,蒋建家,黄子成,等  点击次数:427次  下载次数:79次

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【摘要】:目的明确腹腔内脂肪面积(VAT)正常的非酒精性脂肪性肝病(NAFLD)的危险因素及其胰岛素抵抗(IR)状态。方法 选取2017年6月-2018年5月福建医科大学附属泉州第一医院收集的45例VAT正常的NAFLD患者为观察组,另取同期27例VAT正常且非NAFLD者作为对照组。分别测定2组对象的VAT、腰围、空腹血糖(FBG)、空腹胰岛素(FINS)等指标,计算IR指数(HOMA-IR),并分析IR与腰围等指标的相关性。正态分布的计量资料2组间比较采用独立样本t检验,非正态分布者采用Mann-Whitney U检验,计数资料2组间比较采用χ2检验。正态分布的计量资料相关性比较采用Pearson相关分析,非正态分布者采用Spearman相关分析。危险因素分析采用logistic回归分析(向前法)。结果VAT正常的NAFLD组IR水平较对照组高,HOMA-IR 2组间差异有统计学意义[2.66(1.59~4.06) vs 1.84(1.25~2.47),Z=364.000,P=0.005];IR与FBG、FINS、TG呈正相关,r值分别为0.412、0789、0.306(P值<005),与HDL呈负相关(r=-0398,P<005)。多因素回归分析显示,腰围为VAT正常NAFLD的独立危险因素,回归系数为0.181,比值比为1.198(95%可信区间:1.099~1.306),P<0.001。结论VAT正常的NAFLD已经存在一定程度的IR;腰围是VAT正常的NAFLD的独立危险因素。
【Abstract】:ObjectiveTo investigate the risk factors and insulin resistance (IR) of nonalcoholic fatty liver disease (NAFLD) with a normal visceral adipose tissue (VAT) area. MethodsA total of 45 NAFLD persons with a normal VAT area who were admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2017 to May 2018 were enrolled as observation group, and 27 non-NAFLD patients with a normal VAT area were enrolled as control group. VAT area, waist circumference, fasting blood glucose (FBG), and fasting insulin (FINS) were measured for both groups, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated, and the correlation of IR with the indices including waist circumference was analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation of normally and non-normally distributed continuous data. A forward logistic regression analysis was used to identify related risk factors. ResultsThe NAFLD group had a significantly higher level of IR than the control group, and there was a significant difference in HOMA-IR between the two groups (2.66(1.59-4.06) vs 1.84(125-2.47), Z=364.000, P=0005). IR was positively correlated with FBG (r=0.412, P=0.005), FINS (r=0.789, P<0001), and TG (r=0.306, P=0041). IR was negatively correlated with HDL(r=-9398,P=0007). The multivariate regression analysis showed that waist circumference was an independent risk factor for NAFLD with a normal VAT area (regression coefficient = 0.181, odds ratio = 1.198, 95% confidence interval: 1.099-1.306, P<0.001). ConclusionThere is a certain degree of IR in NAFLD patients with a normal VAT, and waist circumference is an independent risk for NAFLD with a normal VAT.
【关键字】:非酒精性脂肪性肝病; 腹内脂肪; 危险因素
【Key words】:non-alcoholic fatty liver disease; intra-abdominal fat; risk factors
【引证本文】:HUANG ZP, JIANG JJ, HUANG ZC, et al. Risk factors of nonalcoholic fatty liver disease with a normal visceral adipose tissue area[J]. J Clin Hepatol, 2019, 35(5): 1061-1064. (in Chinese)
黄志鹏, 蒋建家, 黄子成, 等. 腹腔内脂肪面积正常的非酒精性脂肪性肝病的危险因素分析[J]. 临床肝胆病杂志, 2019, 35(5): 1061-1064.

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