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脂肪肝相关危险因素的研究

Risk Factors for Fatty Liver Disease

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【作者】 曹男林连捷郑长青林艳王东旭

【Author】 CAO Nan,LIN Lian-jie,ZHENG Chang-qing,et al.Department of Gastroenterology,Shengjing Hospital of China Medical University,Shenyang 110004,China

【机构】 中国医科大学附属盛京医院消化内科

【摘要】 目的探讨脂肪肝发病的相关危险因素。方法选取2011年3—8月具有完整资料的中国医科大学附属盛京医院体检中心的健康体检者1 067例,通过问卷调查、体格检查、实验室检测及腹部超声检查对脂肪肝组的年龄、性别、体质指数、血压、血糖、血脂、血尿酸、肝功能及血常规检测结果与非脂肪肝组进行对比分析。结果1 067例体检者中,超声诊断出脂肪肝430例(40.30%),其中男274例(47.65%),女156例(31.71%),二者检出率间差异有统计学意义(χ2=28.018,P<0.01);月收入≥3 000元者检出脂肪肝263例(47.05%,263/559),<3 000元检出脂肪肝167例(32.87%,167/508),二者检出率间差异亦有统计学意义(χ2=22.225,P<0.01)。不同职业者脂肪肝的检出率不间差异有统计学意义(χ2=55.260,P<0.05)。脂肪肝组与非脂肪肝组在喜肥食、吸烟、慢性饮酒、经常锻炼方面差异有统计学意义(P<0.05)。脂肪肝组超重、肥胖、糖代谢紊乱、高血压、血脂异常、高尿酸血症的患病率高于非脂肪肝组,差异有统计学意义(P<0.05)。单因素分析显示,脂肪肝组体质指数、收缩压、舒张压、尿酸等均高于非脂肪肝组,差异有统计学意义(P<0.001),而高密度脂蛋白胆固醇、载脂蛋白A1则低于非脂肪肝组,差异亦有统计学意义(P<0.001)。多因素Logistic回归结果显示年龄、性别(男性)、体质指数、舒张压、收缩压、尿酸、载脂蛋白B、载脂蛋白A1、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油、空腹血糖12项指标进入了回归方程(P<0.05)。结论吸烟、饮酒、喜肥食、缺少锻炼等不良生活习惯和超重、肥胖、高血压、糖代谢紊乱、血脂异常、高尿酸血症都增加了脂肪肝的患病风险。年龄、性别、体质指数、收缩压、舒张压、尿酸、载脂蛋白B、低密度脂蛋白胆固醇、三酰甘油、空腹血糖是脂肪肝发病的危险因素。

【Abstract】 Objective To investigate the risk factors for fatty liver disease.Methods A total of 1 067 cases with complete information in our physical examination center between March 2011 and August 2011 were selected in this study.The age,gender,body mass index,blood pressure,fasting blood glucose,blood lipids,blood uric acid,liver function and routine blood examination results were compared between the fatty liver group and non-fatty liver group using questionnaire survey,physical examination,laboratory test,and abdominal ultrasound examination.Results A total of 430 cases of fatty liver were detected out of 1 067 cases(40.30%) using abdominal ultrasound examination,including 274 male patients and 156 female patients.The prevalence of fatty liver disease was higher in males than in females(47.65% vs.31.71%)(χ2=28.018,P<0.01).The prevalence was higher in people with monthly earning ≥3 000 RMB(47.05%,263/559) than in people with monthly earning <3 000 RMB(χ2=22.225,P<0.01).The prevalence varied in people with different occupations(χ2=55.260,P<0.05).Significant difference was observed between the two groups in diet and living habits,such as fatty food consumption,smoking,alcohol consumption,and exercise(P<0.05).The prevalence of overweight,obesity,glucose metabolism disorder,hypertension,hyperlipidemia,and hyperuricemia was higher in fatty liver group than in non-fatty liver group.Univariate analysis showed that the fatty liver group had significantly higher body mass index,systolic blood pressure,diastolic blood pressure,and uric acid,but significantly lower high-density lipoprotein cholesterol and apolipoprotein A1 than the non-fatty liver group(P<0.001).Multiple regression analysis showed that age,gender,body mass index,systolic blood pressure,diastolic blood pressure,uric acid,apolipoprotein B,apolipoprotein A1,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglycerides,fasting-serum glucose level were risk factors for fatty liver disease(P<0.05).Conclusion Unhealthy lifestyles like smoking,alcohol consumption,fatty food consumption,and lack of exercise,as well as overweight,obesity,hypertension,glucose metabolism disorder,dyslipidemia,and hyperuricemia increase the risks for fatty liver diseases.

【关键词】 脂肪肝; 危险因素; 代谢综合征; 生活习惯;

【Key words】 Fatty liver disease; Risk factors; Metabolic syndrome; Life style;

【分类号】R575.5;R181.13;R589.1;

【基金】 辽宁省科学技术基金资助项目(2010225008);辽宁省博士科研启动基金资助项目(20081048);沈阳市科学技术基金资助项目(F10-205-1-17)

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