非酒精性脂肪性肝病患者血清糖化血红蛋白水平变化研究*

doi:10.3969/j.issn.1672-5069.2016.02.013

实用肝脏病杂志 ›› 2016, Vol. 19 ›› Issue (2): 175-179.doi: 10.3969/j.issn.1672-5069.2016.02.013

非酒精性脂肪性肝病患者血清糖化血红蛋白水平变化研究^*

邵庆华, 郑盛, 杨涓, 张帆, 唐映梅

650011 昆明市云南省第三人民医院肝病中心（邵庆华,郑盛,杨涓,张帆）; 昆明医科大学第二附属医院肝病中心（唐映梅）

收稿日期:2015-07-13 出版日期:2016-03-10 发布日期:2016-03-04
通讯作者: 唐映梅,E-mail：tangyingmei_med@163.com
作者简介:邵庆华,男,54岁,医学硕士,主任医师。主要从事慢性肝病临床研究。E-mail：53573885@qq.com 共同郑盛,男,35岁,医学硕士,主治医师。E-mail：zheng_sheng523@163.com
基金资助:
国家自然科学基金（81360072）; 云南省自然科学基金（2012FD095）; 云南省教育厅科研基金重点项目（2014Z125）; 云南省临床重点专科建设项目〔云卫医发（2015）18号〕

Changes of serum glycosylated hemoglobin in patients with non-alcoholic fatty liver diseases

Shao Qinhua, Zheng Sheng, Yang Juan

Department of Liver Diseases,Third Provincial People’s Hospital,Kunming 650011,Yunnan Province,China

Received:2015-07-13 Online:2016-03-10 Published:2016-03-04

摘要/Abstract

摘要： 目的探讨成年居民血清糖化血红蛋白(HbA1C）水平与非酒精性脂肪性肝病(NAFLD）的关系。方法调查符合入选条件的12381名年龄18岁及其以上的昆明市社区居民,测定其腰围、体质指数（BMI）、血压、空腹血糖、血脂谱、γ-谷氨酰转肽酶（γ-GT）和HbA1c,并行上腹部B超检查。按HbA1C水平的四分位数进行分层,分为Q1~Q4组（HbA1C水平分别为：Q1组≤5.2%,5.2%<Q2组≤5.4%,5.4%<Q3组≤5.6%,Q4组>5.6%）,分析各组NAFLD患病率及临床特征,并采用Logistic多元回归分析NAFLD患病的危险因素。结果在本组被调查人群中,NAFLD患病率为27.2%,其中男性为31.9%,女性为21.0%,男性患病率较女性高(P<0.001）;Q1、Q2、Q3、Q4组NAFLD患病率分别为18.5%(534/2883）、22.8%(555/2436）、25.6%(840/3285）、38.1%(1440/3777）,即随着血HbA1C水平的升高,NAFLD患病率逐渐升高;3369例NAFLD患者收缩压、TC、LDL-C、空腹血糖均随着HbA1c水平的升高而递增;Logistic多元回归分析显示高HbA1C水平为NAFLD患病的危险因素(0R=1.67,95%CI 1.15~2.43,P=0.007）。结论血HbA1C是NAFLD患病的危险因素,且两者都与血脂代谢紊乱联系紧密。

关键词: 非酒精性脂肪性肝病, 成年居民, 糖化血红蛋白, 危险因素

Abstract: Objective To study the correlation between serum glycosylated hemoglobin（HbA1c） and non-alcoholic fatty liver diseases（NAFLD）. Methods A total of 12381 adult residents aged above 18 years in Kunming were enrolled in this study. The data including the waistline, body mass index（BMI）,blood pressure, fasting blood-glucose,blood lipids,glutamyltranspeptidase,HbA1c and the results of epigastrial B ultrasonography were recorded. According to the quartile of HbA1c levels,the participants were divided into four groups,e.g.,the HbA1c≤5.2% in Q1 group,5.2%<Q2 group≤5.4%,5.4%<Q3 group≤5.6%,and>5.6% in Q4 group. Logistic regression was conducted to predict independent risk factors for NAFLD. ResultsThe overall incidence of NAFLD in our series was 27.2% with 31.9% in male and 21.0% in female,which was significantly different （P<0.001）;The incidences of NAFLD in Q1,Q2,Q3 and Q4 group were 18.5% （534/2883）,22.8% （555/2436）,25.6%（840/3285） and 38.1%（1440/3777）,respectively,suggesting that the incidence of NAFLD increased with the rising HbA1c level;The systolic pressure,total cholesterol, low density lipoprotein cholesterol and fasting blood-glucose in 3369 NAFLD patients also elevated as blood HbA1c levels increased;Multiple Logistic regression analysis indicated that high HbA1c level was the risk factor for the incidence of NAFLD（OR=1.7,95%CI 1.2~2.4,P=0.007）. ConclusionBlood HbA1c levels is an independent risk factor for NAFLD and both of them are closely related to disorders of blood lipid metabolism.

Key words: Non-alcoholic fatty liver disease, Adult residents, Glycosylated hemoglobin, Risk factors

邵庆华, 郑盛, 杨涓, 张帆, 唐映梅. 非酒精性脂肪性肝病患者血清糖化血红蛋白水平变化研究^*[J]. 实用肝脏病杂志, 2016, 19(2): 175-179.

Shao Qinhua, Zheng Sheng, Yang Juan. Changes of serum glycosylated hemoglobin in patients with non-alcoholic fatty liver diseases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(2): 175-179.

参考文献

[1] 郑盛,唐映梅. 非酒精性脂肪性肝病诊治进展. 中国全科医学,2013,16（2）:117-119.
[2] 郑盛,杨晋辉,尤丽英,等. 体检人群非酒精性脂肪性肝病与代谢综合征相关指标的关系研究. 中国全科医学,2013,16（7）:605-607.
[3] Li G,Hu H,Shi W,et al. Elevated hematocrit in nonalcoholic fatty liver disease:a potential cause for the increased risk of cardiovascular disease. Clin Hemorheol Microcirc,2012,51（1）:59-68.
[4] 刘安楠,朱玲,潘洁,等. 北京地区体检人群脂肪肝患病率及危险因素分析. 胃肠病学和肝病学杂志,2009,18（4）:357-359.
[5] Koo SH. Nonalcoholic fatty liver disease:molecular mechanisms for the hepatic steatosis. Clin Mol Hepatol,2013,19（3）:210-215.
[6] Issa D,Albeldawi M,Lopez R,et al. Hematocrit levels and red blood cell indices in patients with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol,2014,26（3）:363-364.
[7] Fan JG. Epidemiology of alcoholic and nonalcoholic fatty liver disease in China. J Gastroenterol Hepatol,2013,28（Suppl 1）:11-17.
[8] Ortiz D,Briceno JC,Cabrales P. Microhemodynamic parameters quantification from intravital microscopy videos. Physiol Meas, 2014,35（3）:351-367.
[9] 丁雯瑾,范建高. 世界胃肠病组织非酒精性脂肪性肝病诊疗指南简介. 实用肝脏病杂志,2014,17（5）:1-3.
[10] Bae JC,Cho YK,Lee WY,et al. Impact of nonalcoholic fatty liver disease on insulin resistance in relation to HbA1c levels in nondiabetic subjects. Am J Gastroenterol,2010,105（11）:2389-2395.
[11] 王军,魏艳玲,范丽玲,等. 非酒精性脂肪性肝病与心血管疾病的相关性研究. 实用肝脏病杂志,2013,16（6）:499-501.
[12] Demir M,Demir C,Cosar S. The relationship between serum bilirubin concentration and coronary slow flow. Ther Adv Cardiovasc Dis,2013,7（6）:316-321.
[13] Yeh MM,Brunt EM. Pathological features of fatty liver disease. Gastroenterology,2014,147（4）:754-764.
[14] Prashanth M,Ganesh HK,Vima MV,et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus. J Assoe Physicians India,2009,57:205-210.
[15] Samuel VT,Liu ZX,Qu X,et a1. Mechanism of hepatic insulin resistance in non-alcoholic fatty liver disease. J Biol Chem,2004,279（31）:32345-3253.
[16] 茅益民,曾民德. 加强非酒精性脂肪性肝病的临床和转化医学研究. 实用肝脏病杂志,2012,15（4）:273-275.
[17] Rahimi RS,Landaverde C. Nonalcoholic fatty liver disease and the metabolic syndrome:clinical implications and treatment. Nutr Clin Pract,2013,28（1）:40-51.
[18] Kostapanos MS,Kei A,Elisaf MS. Current role of fenofibrate in the prevention and magagement of non-alcoholic fatty liver disease. World J Hepatol,2013,5（9）:470-478.
[19] Ma H,Xu C,Xu L,et al. Independent association of HbA1c and nonalcoholic fatty liver disease in an elderly Chinese population. BMC Gastroenterol,2013,13:3.
[20] 袁松松,向天新,刘娟,等. 133例肝硬化并发糖尿病患者发病相关危险因素和预后分析. 实用肝脏病杂志,2015,18（1）:43-46.

非酒精性脂肪性肝病患者血清糖化血红蛋白水平变化研究^*

Changes of serum glycosylated hemoglobin in patients with non-alcoholic fatty liver diseases

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