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选取2006年4月~2010年1月期间在湖南省人民医院体检的人员中资料齐全、于1~3年后随访的1 367例,比较正常对照组、代谢正常肥胖(Metabolically Healthy Obese,MHO)及肥胖伴代谢综合征(MS)三组的血清谷丙转氨酶(alanine aminotransferase,ALT)活性.将血清ALT活性正常的MHO(n=40)行四分位数分组(A、B、C、D组),比较4组MHO个体发生非酒精性脂肪性肝病(NAFLD)的发病情况,分析不同组别发生NAFLD的风险.结果:(1)MHO个体ALT水平低于肥胖伴MS者(30.71±19.59 vs 39.47±27.56,P<0.05),高于正常对照者(30.71±19.59 vs 21.39±14.98,P<0.05).(2)血清ALT活性正常的MHO个体发生NAFLD的风险较正常对照组明显增加(55%vs 5.71%,OR=20.167,95%CI:8.594~47.323;P<0.05).(3)D组发生NAFLD风险明显增高(80%vs30%,OR=9.333,95%CI:1.193~72.991;P<0.05).证明正常范围内较高活性的ALT可预测MHO个体中NAFLD的发生.
A total of 1 367 follow-up patients from January 2006 to January 2010 in Hunan Provincial People’s Hospital were enrolled in the study. Metabolically Healthy Obese (MHO) And metabolic syndrome (MS) .Serum alanine aminotransferase (ALT) activity was measured in all three groups.MHO (n = 40) with normal serum ALT activity was divided into four groups: A, B, C and D Group), and compared the incidence of non-alcoholic fatty liver disease (NAFLD) in 4 groups of MHO individuals and analyzed the risk of NAFLD in different groups.Results: (1) The ALT level in MHO individuals was lower than that in obese MS patients (30.71 ± 19.59 (30.71 ± 19.59 vs 21.39 ± 14.98, P <0.05). (2) The risk of developing NAFLD in MALT individuals with normal serum ALT activity was significantly higher than that of the normal control group (P <0.05 vs 39.47 ± 27.56, P < 55% CI: 8.594 ~ 47.323; P <0.05). (3) The risk of NAFLD in group D was significantly higher than that in group D (80% vs 30%, OR = 9.333, 95% CI: 1.193 ~ 72.991 ; P <0.05) .It is demonstrated that ALT with higher activity in the normal range can predict the occurrence of NAFLD in MHO individuals.