摘要
目的分析正常体质指数人群血尿酸水平与非酒精性脂肪性肝病的相关性。方法回顾性调查2014年4至9月接受年度健康体检的血尿酸水平正常的2 193名正常体质指数体检者（男性1 106人，女性1 087人）。脂肪肝根据B超检查确定，代谢异常的判定采用美国国家胆固醇教育计划成人治疗方案第3次报告的中国人修订标准。按照血尿酸水平分布把男性和女性体检者的尿酸分别分为四分位水平[Q1~Q4，Q1为最低水平]。危险因素分析采取Logistic回归分析并校正混杂因素，选取血尿酸Q1水平为参考标准，分析血尿酸与脂肪肝的关系。结果男性和女性脂肪肝组和非脂肪肝组相比，血尿酸比较差异具有统计学意义[男性，（339.0±47.6）μmol/L比（309.3±53.5）μmol/L ，t=3.296，P〈0.01；女性（273.6±41.6）μmol/L比（243.9±47.6）μmol/L，t=3.178，P〈0.01]。在校正年龄、体质指数、腰围、收缩压、舒张压、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转肽酶、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖、肌酐、尿素氮，吸烟和代谢综合征后，男性和女性的血尿酸在Q3和Q4水平患脂肪肝的风险均高于Q1水平[男性，OR （95%CI）分别为2.058 （1.255~ 3.374）和3.383 （2.085~5.490）；女性，OR （95%CI）分别为2.186 （1.090~4.384）和2.420 （1.214~4.821）] （P〈0.05 ）。
结论正常体质指数人群血尿酸水平与脂肪肝独立相关，在正常范围内的血尿酸水平升高可能是脂肪肝的独立危险因素。
ObjectiveSerum uric acid （SUA） levels have been identified to be associated with nonalcoholic fatty liver disease （NAFLD） which is often closely linked to obesity. However, few studies have examined the relationship between SUA levels and NAFLD in normal body mass index （BMI） people in whom NAFLD is noted not uncommon. We conducted this study to assess the association of SUA with NAFLD in Chinese normal-BMI people.MethodsA total of 2 193 normal-BMI people （1 106 men and 1087 women） who participated in a health check-up were enrolled in this cross-sectional study. NAFLD was defined as a hepatic steatosis examined by liver ultrasonography in the absence of a second cause. Multiple regression analysis was performed to examine the relationship between SUA and NAFLD.ResultsCompared with people without NAFLD, those with NAFLD had significantly higher level of serum uric acid [males, （339.0±47.6） μmol/L vs.（309.3±53.5） μmol/L, t=3.296, P〈0.01; female,（273.6±41.6） μmol/L vs. （243.9±47.6） μmol/L, t=3.178, P〈0.01]. Multiple regression analysis revealed that the quartile 3 and 4 of SUA in both sexes had a higher （P〈0.05） odds ratio for the presence of NAFLD than the lowest quartile [males, odds ratio：2.508 （1.255-3.374） and 3.383 （2.058-5.490） ; females, odds ratio：2.186 （1.090-4.384） and 2.420 （1.214-4.821）,respectively],after adjusting for age, body mass index, blood urea nitrogen, serum creatinine, the liver-function test, metabolic components, high sensitivity C-reactive protein, and smoking status.
ConclusionsIncreased SUA level, even within the normal range, are independently associated with the presence of NAFLD among normal-BMI people.
作者
王尊
陈东宁
崔晶
刘思彤
Wang Zun Chen Dongning Cui ring Liu Sitong(Beijing Tongren Hospital Affricated to Capital Medical University, Department of Clinical Nutrition, Beifing 100730, China Department of Medical Examination, Beifing 100730, China)
出处
《中华健康管理学杂志》
CAS
2016年第6期445-449,共5页
Chinese Journal of Health Management
关键词
非酒精性脂肪性肝病
脂肪肝
尿酸
体质指数
Nonalcoholic fatty liver disease
Hepatic steatosis
Uric acid
Body mass index
