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目的:研究血清铁与非酒精性脂肪肝(NAFLD)患病风险的相关性。方法:在上海40岁以上社区居民中进行问卷调查,并进行体格检查、高分辨率超声检查以及血清铁、血脂、胰岛素、空腹及口服葡萄糖耐量试验(OGTT)2 h血糖(2hPG)、肝功能、肾功能等生化检测,对其中数据完整的2120名居民进行分析。分别采用线性回归分析血清铁离子浓度与NAFLD危险因素的相关性,多元Logistic回归模型分析血清铁与NAFLD患病风险之间的关系。结果:NAFLD的患病率为27.4%。从血清铁离子浓度第1四分位组到第4四分位组,NAFLD患病率呈增高趋势,分别为20.8%、29.2%、28.4%、31.2%(组间趋势P=0.0005)。多元Logistic回归分析显示,与血清铁离子浓度第1四分位组(≤14.3 μmol/L)相比,第2四分位组(14.4~17.8 μmol/L)、第3四分位组(17.9~21.9 μmol/L)及第4四分位组(>21.9 μmol/L)NAFLD的患病风险比值比(OR)分别是1.57[95%可信区间(CI):1.19~2.08]、1.51(95%CI:1.14~2.00)、1.72(95%CI:1.30~2.28)(趋势P=0.0005),在校正年龄、性别、吸烟、饮酒、体质量指数(BMI)、收缩压(SBP)、脂代谢指标、空腹血糖对数值(lg FPG)等相关混杂因素后,3组NAFLD患病风险OR分别是1.31(95%CI 0.91~1.89)、1.44(95%CI 0.99~2.09)、1.48(95%CI 1.01~2.19)(趋势P=0.0274)。结论:上海社区40岁以上人群中,高浓度血清铁离子与NAFLD的患病风险显著相关。
Aims: To investigate the association between serum iron and non-alcoholic fatty liver disease (NAFLD). Methods: A questionnaire survey was conducted among 40-year-old residents in Shanghai. Physical examination, high-resolution ultrasonography and serum iron, lipids, insulin, fasting and oral glucose tolerance test (OGTT) 2h blood glucose , Renal function and other biochemical tests, data analysis of the full 2120 residents. Linear regression was used to analyze the correlation between serum iron concentration and NAFLD risk factors, and multivariate logistic regression model was used to analyze the relationship between serum iron and NAFLD risk. Results: The prevalence of NAFLD was 27.4%. The prevalence of NAFLD tended to increase from the first quartile to the fourth quartile of serum iron concentrations, which were 20.8%, 29.2%, 28.4% and 31.2%, respectively (trend between groups, P = 0.0005). Multivariate logistic regression analysis showed that compared with the first quartile (≤14.3 μmol / L) in the serum iron concentration, the second quartile (14.4-17.8 μmol / L), the third quartile (17.9 The risk odds ratio (OR) of ~ (21.9 μmol / L) and NAFLD of the fourth quartile (> 21.9 μmol / L) were 1.57 [95% CI: 1.19-2.08] Age, sex, smoking, alcohol consumption, body mass index (BMI), systolic blood pressure (SBP), lipid (95% CI 0.99 ~ 2.09), 1.48 (95% CI 0.99 ~ 2.09), 1.48 (95% CI 0.99 ~ 2.09), risk of NAFLD CI 1.01-2.19) (trend P = 0.0274). CONCLUSIONS: Serum iron levels in Shanghai population over the age of 40 are significantly associated with the prevalence of NAFLD.