非酒精性脂肪性肝病患者动脉僵硬度的变化及其影响因素分析*

doi:10.3969/j.issn.1672-5069.2016.02.014

实用肝脏病杂志 ›› 2016, Vol. 19 ›› Issue (2): 180-183.doi: 10.3969/j.issn.1672-5069.2016.02.014

非酒精性脂肪性肝病患者动脉僵硬度的变化及其影响因素分析^*

王景玲, 叶文雄, 丘明宇, 童杰, 赵燕, 陈金军

518116 广东省深圳市龙岗中心医院体检科（王景玲,丘明宇,赵燕）; 超声科（叶文雄）; 计算机网络中心（童杰）; 南方医科大学南方医院感染内科肝病中心（陈金军）

收稿日期:2015-09-10 出版日期:2016-03-10 发布日期:2016-03-04
通讯作者: 赵燕,E-mail: zhaoyan26149@163.com
作者简介:王景玲,女,34岁,医学博士,主治医师。主要从事脂肪性肝病等糖脂代谢紊乱相关性疾病研究。E-mail: jingling009@126.com
基金资助:
深圳市龙岗区科技发展资金资助项目（YS 2013074）

Changes of arterial stiffness in patients with nonalcoholic fatty liver diseases

Wang Jingling, Ye Wenxiong, Qiu Mingyu

Department of Physical Examination,Central Hospital,Longgang District,Shenzhen 518116, China

Received:2015-09-10 Online:2016-03-10 Published:2016-03-04

摘要/Abstract

摘要： 目的研究不同年龄段非酒精性脂肪性肝病（NAFLD）患者外周动脉僵硬度的变化,探讨影响动脉僵硬度增高的相关危险因素。方法根据超声检查是否存在脂肪肝将2382例健康体检者分为NAFLD组和无NAFLD组。使用欧姆龙BP-203RPE III动脉硬化检测装置同时检测左右两侧肱踝脉搏波传导速度（baPWV）值。以baPWV≥1400 cm/s为动脉僵硬度增高,采用Logistic回归分析影响动脉僵硬度增高的危险因素。结果在2382例体检者中,发现NAFLD患者935例（39.3%）,在1595例男性中,检出NAFLD 患者726例（45.5%）,在787例女性中,检出NAFLD患者209例（26.6%,P<0.001）;20~39岁年龄段NAFLD组baPWV水平为（1340.0±180.7） cm/s,显著高于无NAFLD组【（1203.9±155.2） cm/s,P<0.001】;40~59岁年龄段NAFLD组baPWV水平为（1437.1±232.6） cm/s,显著高于无NAFLD组【（1355.8±217.9） cm/s,P<0.001】;大于60岁年龄段NAFLD组baPWV水平为（1885.8±404.0） cm/s,与无NAFLD组的baPWV水平【（1830.2±430.6） cm/s】无统计学差别（P>0.05）;不同性别NAFLD对baPWV增高发生率的影响不同,以女性患NAFLD对baPWV影响较大;在1643例血压正常者,采用二分类Logistic回归分析发现,年龄、性别、NAFLD和血清总胆固醇为baPWV升高的独立危险因素。结论NAFLD患者较无NAFLD人群动脉僵硬度增高,以青中年NAFLD患者增高更为明显。NAFLD为动脉僵硬度增高的独立危险因素。

关键词: 非酒精性脂肪性肝病, 动脉粥样硬化, 血管僵硬度

Abstract: Objective To investigate the changes and risk factors of arterial stiffness in patients with nonalcoholic fatty liver diseases（NAFLD）. Methods A total of 2,382 healthy persons were enrolled for physical examination,and the NAFLD was diagnosed by ultrasound monitoring. Brachial ankle pulse wave velocity （baPWV）was determined by a domestic BP-203RPE III arterial stiffness detector,and the baPWV level≥1400 cm/s was arbitrarily believed as the increase of arterial stiffness. Risk factors of baPWV elevation were assessed by using logistic regression analysis. Results Overall,The prevalence of NAFLD was 39.3% among 2382 subjects,45.5% in 1595 men and 26.6% in 787 women,respectively;In individuals between 20 to 39 years old,the baPWV level was significantly higher in NAFLD group than in those without NAFLD[（1340.0±180.7） cm/s vs （1203.9±155.2） cm/s,P<0.001],and the increases baPWV rate was 31.4% vs. 10.5%（P<0.001）;In individuals between 40 to 59 years old,the baPWV was also significantly different between NAFLD patients and non-NAFLD subjects [（1437.1±232.6） cm/s vs.（1355.8±217.9） cm/s,P<0.001],and the increased baPWV rate was 50.1% vs. 33.1%（P<0.001）; However,such difference was not significant among 330 cases over 60 years old;In addition,the effect of NAFLD on baPWV increase was higher in female patients than in males;Logistic analysis showed that NAFLD,age,gender and serum total cholesterol levels were independent risk factors for baPWV increase in individuals with normal blood pressure. Conclusion The baPWV level is higher in individuals with NAFLD,especially in middle-aged ones. NAFLD is an independent risk factor for the baPWV elevation.

Key words: Nonalcoholic fatty liver disease, Arteriosclerosis, Vascular stiffness

王景玲, 叶文雄, 丘明宇, 童杰, 赵燕, 陈金军. 非酒精性脂肪性肝病患者动脉僵硬度的变化及其影响因素分析^*[J]. 实用肝脏病杂志, 2016, 19(2): 180-183.

Wang Jingling, Ye Wenxiong, Qiu Mingyu. Changes of arterial stiffness in patients with nonalcoholic fatty liver diseases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(2): 180-183.

参考文献

[1] 范建高,李锋,蔡晓波,等. 1995至2002年上海宝钢职工队列人群脂肪肝患病率变化.肝脏,2006,11（3）：154-157.
[2] Rafiq N,Bai C,Fang Y,et al. Long-term follow-up of patients with nonalcoholic fatty liver. Clin Gastroenterol Hepatol,2009,7（2）:234-238.
[3] 范建高.脂肪肝促发代谢紊乱和动脉硬化的机制.诊断学理论与实践,2007,6（2）：108-110.
[4] Anstee QM,Targher G,Day CP. Progression of NAFLD to diabetes mellitus,cardiovascular disease or cirrhosis.Nat Rev Gastroenterol Hepatol,2013,10（6）:330-344.
[5] Willum-Hansen T,Staessen JA,Torp-Pedersen C,et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population.Circulation,2006,113（5）:664-670.
[6] 中华医学会肝病学分会脂肪肝和酒精性肝病学组.酒精性肝病诊疗指南（2010年修订版）.中华肝脏病杂志,2010,18（3）:167-170.
[7] 中华医学会肝病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗指南（2010年修订版）.中华肝脏病杂志,2010,18（3）：163-166.
[8] 胡大一. 心血管疾病防治指南和共识2008. 北京:人民卫生出版社,2008:37-43.
[9] Vlachopoulos C,Aznaouridis K,Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol,2010,55（13）:1318-1327.
[10] Elsheikh E,Younoszai Z,Otgonsuren M,et al. Markers of endothelial dysfunction in patients with non-alcoholic fatty liver disease and coronary artery disease. J Gastroenterol Hepatol,2014,29（7）:1528-1534.
[11] Cohn JN. Arteries, myocardium, blood pressure and cardiovascular risk:towards a revised definition of hypertension.J Hypertens,1998,16（12Pt2）:2117-2124.
[12] Lavi S,Bae JH,Rihal CS,et al. Segmental coronary endothelial dysfunction in patients with minimal atherosclerosis is associated with necrotic core plaques. Heart,2009,95（18）:1525-1530.
[13] Villanova N,Moscatiello S,Ramilli S,et al. Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology,2005,42（2）:473-480.
[14] Targher G,Bertolini L,Padovani R,et al. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease. Diabetes Care,2006,29（6）:1325-1330.
[15] 曹一显,李良平.非酒精性脂肪性肝炎与内皮功能异常和动脉粥样硬化的关系.中华肝脏病杂志,2014,22（3）:205-208.
[16] Sookoian S,Castano GO,Burgueno AL,et al. Circulating levels and hepatic expression of molecular mediators of atherosclerosis in nonalcoholic fatty liver disease.Atherosclerosis,2010,209（2）:585-591.
[17] 徐瑞霞,李建军.氧化型低密度脂蛋白胆固醇与动脉粥样硬化.中国医学前沿杂志（电子版）,2012,4（8）:33-37.
[18] Marinou K,Adiels M,Hodson L,et al. Young women partition fatty acids towards ketone body production rather than VLDL-TAG synthesis,compared with young men.Br J Nutr,2011,105（6）:857-865.
[19] Kim BJ,Kim NH,Kim BS,et al. The association between nonalcoholic fatty liver disease,metabolic syndrome and arterial stiffness in nondiabetic,nonhypertensive individuals. Cardiology,2012,123（1）:54-61.
[20] Zhu WH,Fang LZ,Lu CR,et al. Correlation between non-alcoholic fatty liver with metabolic risk factors and brachial-ankle pulse wave velocity. World J Gastroenterol,2015,21（35）:10192-10199.
[21] 施军平,范建高. 2009年非酒精性脂肪性肝病临床研究进展回顾. 实用肝脏病杂志,2010,13（1）:1-3,15.
[22] 林光宇,林金秀. 高血压患者各节段动脉弹性功能的相关性及影响因素分析. 临床心血管病杂志,2011,27（8）:577-582.
[23] 范建高,潘勤. 加强高脂血症脂肪肝的基础和临床研究.实用肝脏病杂志,2011,14（4）:241-242.

非酒精性脂肪性肝病患者动脉僵硬度的变化及其影响因素分析^*

Changes of arterial stiffness in patients with nonalcoholic fatty liver diseases

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