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目的分析非酒精性脂肪肝(NAFLD)患者和健康对照组的一般特征和临床指标,探讨其相关危险因素,为防治提供依据。方法根据B超检查诊断,体检患者分为正常对照组(4 086例)和NAFLD病例组(1 699例),比较两组人群的一般特征和各临床指标。结果各年龄段NAFLD的患病率有明显的性别差异。NAFLD病例组身体质量指数(BMI)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FBG)、尿酸(UA)、收缩压(SBP)、舒张压(DBP)均显著升高,而高密度脂蛋白胆固醇(HDL-C)显著降低(P<0.05)。logistic回归分析显示BMI(OR为4.30)、TG(OR为1.94)、FBG(OR为1.86)、舒张压(OR为1.02)、HDL-C(OR为0.61)、LDL-C(OR为1.27)、ALT(OR为1.02)、AST/ALT(OR为0.40)进入方程,是独立危险因素(P<0.05)。与NAFLD关系较为密切的指标是BMI、TG、FBG和LDL-C,可较好地预测NAFLD。结论 NAFLD患者具有肥胖、糖脂代谢紊乱(高FBG、高TG、高LDL-C、低HDL-C)、高血压、高尿酸的特征,且肝酶升高。BMI、FBG、TG、HDL-C、LDL-C、DBP、ALT是发生NAFLD的独立危险因素。另外,女性雌激素水平的降低可能是NAFLD的致病因素。
Objective To analyze the general characteristics and clinical indexes of patients with non-alcoholic fatty liver disease (NAFLD) and healthy controls, and to explore the related risk factors to provide the basis for prevention and treatment. Methods According to the diagnosis of B-ultrasound, the physical examination patients were divided into normal control group (4 086 cases) and NAFLD case group (1 699 cases). The general characteristics and clinical indexes of the two groups were compared. Results The prevalence of NAFLD in all age groups showed significant gender differences. Body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), fasting blood glucose (FBG), uric acid (UA) Systolic blood pressure (SBP) and diastolic blood pressure (DBP) increased significantly, while HDL-C decreased significantly (P <0.05). Logistic regression analysis showed that BMI (OR 4.30), TG (OR 1.94), FBG (OR 1.86), diastolic blood pressure (OR 1.02), HDL-C , ALT (OR 1.02) and AST / ALT (OR 0.40) into the equation were independent risk factors (P <0.05). The indexes closely related to NAFLD are BMI, TG, FBG and LDL-C, which can predict NAFLD better. Conclusion NAFLD patients with obesity, dyslipidemia (high FBG, high TG, high LDL-C, low HDL-C), hypertension, high uric acid characteristics, and elevated liver enzymes. BMI, FBG, TG, HDL-C, LDL-C, DBP, ALT are independent risk factors of NAFLD. In addition, the reduction of estrogen levels in women may be the causative factor of NAFLD.