| 王凯丹,杨 英,狄文慧,高文月,杨孟孟.健康体检人群非酒精性脂肪肝病的影响因素分析及对肾功能和亚临床动脉粥样硬化的影响[J].,2024,(3):492-496 |
| 健康体检人群非酒精性脂肪肝病的影响因素分析及对肾功能和亚临床动脉粥样硬化的影响 |
| Analysis of Influencing Factors of Nonalcoholic Fatty Liver Disease in Health Examination Population and its Effects on Renal Function and Subclinical Atherosclerosis |
| 投稿时间：2023-07-04 修订日期：2023-07-27 |
| DOI：10.13241/j.cnki.pmb.2024.03.017 |
| 中文关键词: 健康体检人群 非酒精性脂肪肝病 影响因素 肾功能 亚临床动脉粥样硬化 |
| 英文关键词: Health examination population Nonalcoholic fatty liver disease Influencing factors Renal function Subclinical atherosclerosis |
| 基金项目:国家自然科学基金项目（81561128020） |
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| 中文摘要: |
| 摘要 目的：分析健康体检人群非酒精性脂肪肝病（NAFLD）的影响因素，并观察NAFLD患者肾功能和亚临床动脉粥样硬化相关指标的变化情况。方法：以2019年5月至2022年8月期间到解放军总医院第二医学中心进行普通健康体检者1398例为研究对象，其中确诊为NAFLD纳为病例组，其余纳为对照组。以单因素和多因素logistic回归分析方法分析健康体检人群NAFLD的影响因素，并观察NAFLD患者肾功能[血肌酐（Scr）、尿素氮（BUN）、血尿酸（UA）、肾功能受损发生率]和亚临床动脉粥样硬化相关指标[内膜中层厚度（cIMT）、颈总动脉僵硬度指数（β）、血管压力-应变弹性系数（Ep）、单点脉搏波传导速度（PWVβ）]的变化情况。结果：1398例研究对象中，完成全部调查的1372例，完成率为98.14%（1372/1398）。其中确诊为NAFLD的有184例，纳为病例组，其余1188例纳为对照组。检出率为13.41%（184/1372）。单因素分析结果显示，NAFLD的发病与性别、体重指数、文化程度、工作性质、居住地、运动锻炼情况、喜好荤食、喜好甜食、高血压史、高血脂史、糖尿病史、NAFLD家族史、TG、空腹血糖、HDL-C、LDL-C、TC有关（P<0.05）。多因素Logistic回归分析模型结果显示，性别为男、体重指数偏高、喜好荤食、喜好甜食、TG偏高、空腹血糖偏高、LDL-C偏高、TC偏高、HDL-C偏低是NAFLD发生的危险因素，而运动锻炼情况≥30 min/d是NAFLD发生的保护因素（P<0.05）。病例组的Scr、BUN、UA、肾功能受损发生率高于对照组（P<0.05）。病例组的cIMT、β、Ep、PWVβ均高于对照组（P<0.05）。结论：性别为男、体重指数偏高、喜好荤食、喜好甜食、TG偏高、空腹血糖偏高、LDL-C偏高、TC偏高、HDL-C偏低是NAFLD发生的危险因素，运动锻炼情况≥30 min/d是NAFLD发生的保护因素。NAFLD患者存在肾功能损伤和亚临床动脉粥样硬化风险，值得引起临床重视。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the influencing factors of nonalcoholic fatty liver disease (NAFLD) in healthy people, and to observe the changes of renal function and subclinical atherosclerosis relate indexes in NAFLD patients. Methods: 1398 patients who underwent general health examination in The Second Medical Center of Chinese PLA General Hospital from May 2019 to August 2022 were selected as study subjects, NAFLD was diagnosed as case group among study subjects, and the rest as control group. The influencing factors of NAFLD in healthy people were analyzed by univariate and multivariate logistic regression analysis, and the changes of renal function [serum creatinine (Scr), urea nitrogen (BUN), serum uric acid (UA), incidence of impaired renal function] and subclinical atherosclerosis-related indicators [intima-media thickness (cIMT), common carotid artery stiffness index (β), vascular pressure-strain elasticity coefficient (Ep), and single-point pulse wave velocity (PWVβ)] in NAFLD patients were observed. Results: Of the 1398 subjects, 1372 completed the survey, with a completion rate of 98.14% (1372/1398). 184 cases were diagnosed as NAFLD among study subjects, which were included in case group, and the remaining 1188 cases were included in control group.The detection rate was 13.41% (184/1372). The results of univariate analysis showed that, the incidence of NAFLD was related to gender, body mass index, education level, nature of work, place of residence, exercise, preference for meat, preference for sweets, history of hypertension, history of hyperlipidemia, history of diabetes, family history of NAFLD, TG, fasting blood glucose, HDL-C, LDL-C and TC (P<0.05). The results of multivariate logistic regression analysis showed that, male gender, high body mass index, preference for meat, preference for sweets, high TG, high fasting blood glucose, high LDL-C, high TC and low HDL-C were risk factors for NAFLD, while exercise≥30 min/d was a protective factor for NAFLD (P<0.05). The Scr, BUN, UA and incidence of renal dysfunction in case group was higher than that in control group (P<0.05). The cIMT, β, Ep and PWVβ in case group were higher than those in control group (P<0.05). Conclusion: Male gender, high body mass index, preference for meat, preference for sweets, high TG, high fasting blood glucose, high LDL-C, high TC and low HDL-C were risk factors for NAFLD, while exercise≥30 min/d was a protective factor for NAFLD. NAFLD patients have the risk of renal function damage and subclinical atherosclerosis, which is worthy of clinical attention. |
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