摘要
目的对非酒精性脂肪性肝病(NAFLD)人群进行分析,探索NAFLD患者生化特点以及与其他相关疾病的关系。方法回顾性分析7 843例体检队列,纳入NAFLD患者2 088例。按彩超诊断标准,分为轻度脂肪肝(1 549例),中度脂肪肝(517例),重度脂肪肝(22例)三组。分析三组NAFLD临床基本特征及生化指标,以及合并肾病、心肌缺血、高血压、胆系疾病(胆囊息肉、胆囊结石、胆管结石、胆囊切除)、甲状腺结节等差异。结果 NAFLD在人群中的患病率为26.62%(2 088/7 843),男性患病率31.75%,女性患病率18.11%。NAFLD患者发病年龄(47.22±13.07)岁;NAFLD患者(2024例)的BMI为(27.00±3.36)kg/m2,轻、中、重度NAFLD患者的BMI差异有统计学意义(P<0.001),随着NAFLD疾病程度增加,BMI也增加。NAFLD患者轻、中、重三组的尿酸(P<0.001)、空腹血糖(P<0.001)、总胆固醇水平(P=0.013)、甘油三酯(P<0.001)、低密度脂蛋白(P=0.047)、低/高密度脂蛋白比值(P<0.001)、高密度脂蛋白(P=0.027)、谷丙转氨酶(P<0.001)、谷草转氨酶(P<0.001)、谷胺酰转肽酶(P<0.001)差异有统计学意义。其中空腹血糖、甘油三酯、谷丙转氨酶、谷胺酰转肽酶随着NAFLD疾病严重程度的增加有升高趋势。肌酐、尿素氮、总胆红素、直接胆红素、间接胆红素、碱性磷酸酶水平在NAFLD轻、中、重三组中差异无统计学意义(P>0.05)。NAFLD疾病程度与尿酸(R=0.165,P<0.001)、谷丙转氨酶(R=0.251,P<0.001)、谷草转氨酶(R=0.168,P<0.001)、BMI指数(R=0.251,P<0.001)具呈明显正相关。尿蛋白(P=0.033)、胆囊息肉(P=0.001)、甲状腺结节(P=0.025)在NAFLD轻、中、重三组中的阳性率差异有统计学意义,但无随NAFLD严重程度增加趋势。胆囊炎(P=0.153)、胆系结石(P=0.883)在NAFLD三组患者中的患病率差异无统计学意义。心肌缺血(P=0.023)、高血压(P=0.001)、肾脏早期损伤(尿微量白蛋白阳性)(P=0.039)在轻、中、重NAFLD患者中的阳性率差异具有�
Objective To investigate biochemical characteristics of nonalcoholic fatty liver disease（NAFLD） and its association with other related diseases. Methods 2 088 patients with NAFLD were analyzed retropectively in a cohort of7 843 cases of physical examination. The characteristics of 2 088 NAFLD patients by ultrasound critieria were divided into mild NAFLD group（1 549 cases）,moderate NAFLD group（517 cases）,severe NAFLD group（22 cases）. Clinical characteristics and biochemical indexes of three groups were analyzed. The relevance of the nephropathy,myocardial ischemia,hypertension,biliary diseases（gallbladder polyps,gallbladder stones,bile duct stones,cholecystectomy）,thyroid nodules and NAFLD were also been explored. Results The prevalence rate of NAFLD in the population was26. 62%,and the prevalence rate was 31. 75% in males and 18. 11% in females. The average age was（47. 22 ±13. 07） years old; and the BMI in NAFLD patients（2 024 cases） was（27. 00 ± 3. 36） kg/m2. The BMI in 3 NAFLD groups was statistically significant difference（P〈0. 001）,by NAFLD degree increasing,BMI also increased. The biochemical indicators,such as uric acid（P〈0. 001）,fasting blood glucose（P〈0. 001）,total cholesterol（P =0. 013）,Gansu Three oil ester（P〈0. 001）,low density lipoprotein（P = 0. 047）,low/high density lipoprotein ratio（P〈0. 001）,high density lipoprotein（P = 0. 027）,alanine aminotransferase（P〈0. 001）,aspartate aminotransferase（P〈0. 001）,glutamyl transpeptidase（P〈0. 001） were statistically significant. The levels of fasting blood glucose,triglyceride,alanine aminotransferase,glutamyl transpeptidase were increased by the severity of the disease increasing.The levels of Creatinine,urea nitrogen,total bilirubin,direct bilirubin,indirect bilirubin hormone,alkaline phosphatase were not statistically significant in three NAFLD groups（P〈0. 05）. The levels of uric acid（R = 0. 165,P〈0. 001）,alanine aminotransferase（R = 0. 251,P〈0. 001）,
作者
丁玉平
张文
夏时海
吕成娇
杨梅
毕珣
李海
DING Yuping;ZHANG Wen;XIA Shihai;LYU Chengjiao;YANG Mei;BI Xun;LI Hai(Department of Hepatopancreatobiliary and Splenic Medicine;Medical Examination Centre,Affiliated Hospital,Lo-gistics University of PAP,Tianjin 300162,China)
出处
《胃肠病学和肝病学杂志》
CAS
2018年第8期936-941,共6页
Chinese Journal of Gastroenterology and Hepatology
基金
武警后勤学院博士启动基金资助(WHB201517)
关键词
非酒精性脂肪性肝病
糖脂代谢
肾病
心肌缺血
高血压
Non-alcoholic fatty liver disease
Glycolipid metabolism
Nephropathy
Myocardial ischemia
Hypertension
