德惠市饮酒与酒精性肝病流行病学现况调查及相关因素分析

发布时间：2018-04-23 22:26

本文选题：饮酒 + 酒精性肝病　；参考：《吉林大学》2008年博士论文

【摘要】： 2006年2月,世界卫生组织向中国政府提交了《西太平洋地区减少酒精危害计划》的报告,报告认为中国人在饮酒量、饮酒环境和年消耗量方面严重危害着健康。因此,我国需要通过一套科学评估体系和调查方法来了解中国人的健康饮酒状况。目前许多疾病被证实系由饮酒所致,其中ALD发病率高、危害大。然而,人们对ALD的严重性及危害性认识不足,并且人们认识到遗传组成不同的个体对不同疾病的易感性不同。DNA芯片高通量的特点能够快速准确地得出所需信息,从而实现对ALD易感人群快速准确的筛选。本实验采用多阶段(分层、系统)抽样的方法抽取样本,应用“吉林省城乡居民饮食健康调查问卷”对德惠市6043名18岁以上常住居民进行问卷调查,包括五大类43个询问内容,对其中3815名居民进行了医学体检;对该人群的酒精饮用情况及酒精对肝功、血脂、血压、体重指数、平均红细胞体积等的影响进行了分析;对ALD的患病率进行了统计,并分析与之相关的危险因素;采用Affymetrix Genome-Wide Human SNP Array 5.0芯片对120例ALD全基因组的SNPs位点进行筛查,并进行了酒精代谢酶基因多态性与ALD的关联分析。本次流行病学调查有效问卷6043份。样本饮酒率35.0%,饮酒者平均日饮酒量36.97±48.76g,总酒精摄入量297.90±506.52kg,平均饮酒年限19.21±11.34年,证实饮酒是中国一种较为普遍的社会性行为,随着日饮酒量的增加,γ-GT、AST、ALT、MCV、Chol、TG、LDL-c、HDL-c和BP的平均值逐渐增加,γ-GT、AST、ALT、MCV、Chol、TG、LDL-c、HDL-c和BP与酒精量呈正相关,血脂、肝功、BMI和MCV异常率在饮酒人群和非饮酒人群单因素分析具有统计学意义,Logistic多元回归分析显示地区、年龄、γ-GT、AST、ALT、Chol和MCV与饮酒密切相关。ALD在体检人群中的患病率3.98%,在饮酒者中患病率11.76%,在嗜酒者中患病率44.17%。随着日饮酒量的增加和饮酒年限的延长,ALD的患病率逐渐增加。Logistic多元回归分析显示SBP、γ-GT、AST、LDL-c和酒精量与ALD的发生密切相关。中国人汉族北方种群中共有6个酒精代谢酶的SNPs位点与ALD密切相关。本实验采用标准的流行病学调查方法,首次在吉林省德惠市进行了饮酒及ALD相关危险因素的调查、统计和分析,并对120例ALD人群全基因组的SNPs位点进行筛查及酒精代谢酶基因多态性与ALD的关联分析。明确饮酒与疾病的相关性;了解当前酒精应用的类型和方式、饮酒者的人口学特征,及时获得反映吉林省德惠市当前饮酒及ALD患病情况的代表性统计数据,为国家制定相关卫生和营养政策、开展疾病防治和教育提供科学依据;为进一步开展全国性的调查和在饮酒人群中进行ALD易感者患病风险的筛查、诊断和有效治疗奠定基础。
[Abstract]:In February 2006, the World Health Organization (WHO) submitted to the Chinese government a report on the "Western Pacific region Alcohol Hazard reduction Program", which concluded that Chinese people are seriously harmful to their health in terms of alcohol consumption, drinking environment and annual consumption. Therefore, we need a set of scientific evaluation system and survey methods to understand the healthy drinking status of Chinese people. At present, many diseases have been proved to be caused by alcohol consumption, among which ALD incidence is high and harmful. However, there is a lack of understanding of the severity and harm of ALD, and it is recognized that individuals with different genetic composition have different susceptibility to different diseases. The high throughput characteristics of DNA chips can quickly and accurately obtain the required information. In order to achieve rapid and accurate screening of susceptible populations for ALD. In this experiment, multi-stage (stratified, systematic) sampling method was used to collect samples, and 6043 residents over 18 years old in Dehui city were investigated by "questionnaire on dietary health of urban and rural residents of Jilin Province", including 43 inquiries in five categories. 3815 of them were examined by medical examination, and the effects of alcohol consumption on liver function, blood lipids, blood pressure, body mass index, mean red blood cell volume and so on were analyzed. The prevalence of ALD was analyzed. The Affymetrix Genome-Wide Human SNP Array 5.0 microarray was used to screen SNPs loci in 120 ALD genome, and the association between the polymorphism of alcohol metabolic enzyme gene and ALD was analyzed. There were 6043 valid questionnaires in this epidemiological survey. The average daily alcohol consumption, total alcohol intake and average drinking time were 36.97 卤48.76g, 297.90 卤506.52 kg and 19.21 卤11.34 years, respectively. The results showed that drinking was a common social behavior in China. With the increase of daily alcohol consumption, the average values of LDL-c and BP increased gradually in MCVV Choll TGN LDL-c and BP, and the levels of HDL-c and BP were positively correlated with the amount of alcohol concentrate, and the serum lipids, blood lipid, serum lipids, and serum lipids were positively correlated with the levels of HDL-c and BP. The abnormal rates of MCV and MCV were statistically significant in the univariate analysis of drinkers and non-drinkers. Age, Chol and MCV were closely related to alcohol consumption. The prevalence rate of ALD was 3.98%, 11.76% among drinkers and 44.17% among alcoholics. With the increase of daily alcohol consumption and the prolongation of drinking years, the prevalence rate of ALD increased gradually. Logistic multiple regression analysis showed that SBP, 纬 -GT ASTX LDL-c and alcohol concentration were closely related to the occurrence of ALD. Six SNPs loci of alcohol metabolizing enzymes were closely related to ALD in the northern population of Han nationality in China. By using the standard epidemiological investigation method, the investigation, statistics and analysis of the risk factors related to alcohol consumption and ALD were conducted in Dehui City, Jilin Province for the first time. The SNPs loci of the whole genome of 120 cases of ALD were screened and the association between the polymorphism of alcohol metabolic enzyme gene and ALD was analyzed. To know the types and ways of alcohol use, the demographic characteristics of drinkers, and to obtain the representative statistical data reflecting the current situation of drinking and ALD in Dehui City, Jilin Province, in time, so as to clarify the correlation between alcohol consumption and diseases, understand the types and methods of alcohol use, and obtain the demographic characteristics of drinkers. It provides a scientific basis for the national health and nutrition policy, disease prevention and education, and lays the foundation for further national investigation and screening, diagnosis and effective treatment of the risk of ALD risk among people who are susceptible to ALD.
【学位授予单位】：吉林大学
【学位级别】：博士
【学位授予年份】：2008
【分类号】：R181.3

【引证文献】