体检人群非酒精性脂肪性肝病发病率及其相关危险因素分析*

doi:10.3969/j.issn.1672-5069.2024.03.009

摘要/Abstract

摘要： 目的探讨体检人群非酒精性脂肪性肝病(NAFLD)检出率及其危险因素,为 NAFLD 的防治提供临床依据。方法采用横断面研究方法,共纳入14415名参加2022年度健康体检的人群,常规进行身高、体质量、血压检测,实验室检测包括血脂、血糖、肝功能指标,行腹部肝胆超声检查。应用单因素和多因素Logistic回归分析影响NAFLD发生的危险因素。结果在14415例体检者中,超声检出脂肪肝患者5016例(34.8%),其中男性检出率为47.0%,显著高于女性的21.8%(P＜0.05);NAFLD组体质指数、外周血白细胞和血小板计数分别为(25.8±3.0)kg/m²、(7.0±1.7)×10⁹/L和(263.4±62.4)×10⁹/L,均显著大于非NAFLD组【分别为(21.9±2.6)kg/m²、(6.3±1.6)×10⁹/L和(253.3±55.4)×10⁹/L,P＜0.05】;NAFLD组血清ALP、GGT、TC、TG、LDLC、Glu和UA水平均显著高于非NAFLD组(P＜0.05),而血清HDLC水平显著低于非NAFLD组(P＜0.05);经二分类单因素Logistic回归分析结果显示,年龄、BMI、SBP、DBP、ALT、ALP、GGT、TC、TG、LDLC、Glu、UA、WBC和PLT计数都可能影响NAFLD发生(P ＜ 0.05),而血清HDLC则是保护因素(P＜0.05);进一步分析显示,年龄(OR=1.028)、BMI(OR=1.607)、DBP(OR=1.039)、ALP(OR=1.029)、TG(OR=2.847)、Glu(OR=2.716)和UA(OR=1.005)均是影响NAFLD发生的独立危险因素(P＜0.05),而血清HDL-C水平(OR=0.054)仍是保护因素(P＜0.05)。结论体检人群NAFLD患病率较高,肥胖、血脂和尿酸升高都可能是其发生的危险因素,应予以科学的干预和管理。

关键词: 非酒精性脂肪性肝病, 健康体检, 流行率, 危险因素

Abstract: Objective The aim of this study was to investigate the prevalence and risk factors of non-alcoholic fatty liver diseases (NAFLD) in persons at normal physical examination. Methods A total of 14415 individuals participated annually physical examination in our hospital in 2022, and all had normal routine physical examination (PE), including anthropology, hematology, biochemical parameters and ultrasonography. The univariate and multivariate Logistic regression analysis was applied to reveal the risk factors for the occurrence of NAFLD. Results Out of the 14415 individuals participating PE, the NAFLD was found in 5016 cases(34.8%), with the prevalence of 47.0% in male, much higher than 21.8%(P＜0.05) in female; the body mass index (BMI), white blood cell count and platelet count in patients with NAFLD were (25.8±3.0)kg/m², (7.0±1.7)×10⁹/L and (263.4±62.4)×10⁹/L, all significantly greater than [(21.9±2.6)kg/m², (6.3±1.6)×10⁹/L and (253.3±55.4)×10⁹/L, respectively, P＜0.05] in individuals without NAFLD; serum ALP, GGT, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC), glucose (Glu) and uric acid (UA) levels in patients with NAFLD were significantly higher than in those without NAFLD (P＜0.05), while serum high density lipoprotein cholesterol (HDLC) level was much lower than in those without NAFLD (P＜0.05); the univariate Logistic regression analysis showed that the age, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), ALT, ALP, GGT, TC, TG, LDLC, Glu, UA, white blood cell count and platelet count were all the factors affecting NAFLD occurrence (P ＜ 0.05), while the HDLC level was the protective factor (P＜0.05); the multivariate Logistic regression analysis demonstrated that the age (OR=1.028), BMI(OR=1.607), DBP(OR=1.039), ALP(OR=1.029), TG(OR=2.847), Glu(OR=2.716) and UA(OR=1.005) were the independent risk factors impacting the NAFLD occurrence (P＜0.05), while serum HDL-C level(OR=0.054) was still the protective factor(P＜0.05). Conclusion The prevalence of NAFLD is high in population at PE, and the obesity, hyperlipidemia and hyperuricemia are all the risk factors, which should be properly managed.

Key words: Non-alcoholic fatty liver diseases, Physical examination, Prevalence, Risk factor

农晓黎, 陈菲, 詹浩洪, 罗婷, 曾碧丹. 体检人群非酒精性脂肪性肝病发病率及其相关危险因素分析^*[J]. 实用肝脏病杂志, 2024, 27(3): 353-356.

Nong Xiaoli, Chen Fei, Zhan Haohong, et al. Prevalence and risk factors of nonalcoholic fatty liver disease in individuals for physical examination[J]. Journal of Practical Hepatology, 2024, 27(3): 353-356.

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体检人群非酒精性脂肪性肝病发病率及其相关危险因素分析^*

Prevalence and risk factors of nonalcoholic fatty liver disease in individuals for physical examination

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