广西体检人群脂肪肝检出率及其影响因素的研究

发布时间：2017-12-27 13:35

本文关键词：广西体检人群脂肪肝检出率及其影响因素的研究　出处：《广西医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：了解广西体检人群脂肪肝患病情况及其相关影响因素,为预防和控制脂肪肝的发生提供科学依据。方法：1、调查对象：以2014年5月至2015年11月由广西医科大学第一附属医院体检中心进行体检的来自南宁市、桂平市、容县、平南4个市县部分单位组织的集体体检的5631名健康体检人员作为研究对象。2、资料收集方法：(1)流行病学调查问卷：采用统一设计的流行病学调查问卷进行调查,收集相关的资料,包括研究对象的人口学资料、饮食习惯、工作及运动情况、精神及健康状态。(2)体格检查：包括身高、体重、血压等。(3)实验室检测：包括总胆固醇、甘油三酯和糖化血红蛋白等。(4)B超检查和心电图检查：包括肝、胆、脾、肾等腹部检查。3、统计学方法：将流行病学调查资料、体格检查资料和实验室检查的资料采用EpiData3.1软件进行双录入,建立数据库文件,经一致性检验无误后将数据转为SPSS16.0数据文件。先对资料进行描述性分析,计量资料且呈正态分布的,使用均数±标准差(x±s)进行描述；计数资料采用率或构成比进行描述。在统计描述的基础上进行统计推断,比较脂肪肝人群与非脂肪肝人群的AST、UA、TG、HDL、LDL、红细胞计数等生化指标均数的差异采用两样本均数比较的t检验,不同水平研究因素脂肪肝检出率差异的假设检验采用2检验。影响脂肪肝患病的因素采用非条件Logistic回归模型进行分析,将单因素分析有意义的因素纳入模型进行分析,变量的筛选采用前进法,检验水准为0.05,以P≤0.05为差异具有统计学意义。所有统计分析均使用SPSS16.0统计软件进行。结果：1、研究对象一般情况5631名体检者,南宁市2702名,占47.98%；桂平市2240名,占39.98%；容县374名,占6.64%；平南县315名,占5.59%。男性2968人,占52.7%,女性2663人,占47.3%,男女比例为1.11：1。年龄最小20岁,最大94岁,20-35岁组1654人,占29.4%；35~50岁组2090人,占37.1%；50~65岁组1247人,占22.1%；65岁以上组640人,占11.4%。2、调查对象脂肪肝患病情况调查的5631名体检者,脂肪肝患者1808人,检出率为32.2%。来自南宁市区、桂平市、容县、平南县四个地区的体检人群脂肪肝标化检出率分别为26.27%、37.63%、22.32%、29.18%,差异有统计学意义(χ2=145.1,P0.001)。体检人群中男性脂肪肝检出率显著高于女性(χ2=339.8,P0.01)。按青年、中年、中老年、老年分不同年龄组进行比较,脂肪肝检出率差异有统计学意义(P0.001)。3、研究因素不同水平脂肪肝患病情况超重和肥胖人群脂肪肝检出率分别为50.65%、80.2%,均高于体重正常人群的13.19%(P0.05)。高血压人群脂肪肝检出率52.31%,高于血压正常人群的21.37%(P0.05)。极轻、轻度、中度、重度体力劳动强度的脂肪肝检出率分别为32.4%、35.4%、26.4%、29.0%(P0.05)。睡眠状态中严重不足、不足、一般、充足4个情况脂肪肝检出率为26.5%、30.5%、35.7%、34.3%,四种睡眠状态脂肪肝检出率差异有统计学意义(P0.005)。从不饮酒、偶尔饮酒、戒酒、经常饮酒4种饮酒的不同情况结果显示体检人群脂肪肝检出率分别为26.7%、33.7%、36.6%、41.0%,差异有统计学意义(P0.05)。从不吸烟、偶尔吸烟、戒烟、经常吸烟这4中吸烟情况人群脂肪肝检出率为28.4%、35.4%、37.8,%、41.3%(P0.05)。肉类及肉制品较少、较多、很多三个情况的摄入量脂肪肝检出率分别为31.4%、33.4%、37.4%,差异有统计学意义(P0.05)、鱼类及水产品不吃、较少吃、较多吃的人群脂肪肝检出率分别为21.5%、29.4%、34.4%。清淡、适中、偏咸、高盐4种食盐的不同摄入量脂肪肝检出率为29.9%、37.2%、40.0%,差异有统计学意义(P0.05)。豆类及豆制品不吃、偶尔、经常吃的人群脂肪肝检出率分别为33.9%、25.0%、20.2%,差异有统计学意义(P0.05)。脂肪肝组ALT、AST、UA、BUN、CR、TC、TG等生化指标均值均高于非脂肪肝组；脂肪肝组的高密度脂蛋白均数低于非脂肪肝组,差异均有统计学意义(P0.05)。4、脂肪肝相关因素单因素非条件logistic回归分析结果显示：地区、性别、年龄、超重、肥胖、高血压、经常饮酒、经常吸烟、不同吸烟情况、偶尔和经常吃鱼、高盐饮食、常吃豆制品、睡眠不足、中度劳动强度、高血脂、高尿酸、高血糖、高胆固醇等因素与脂肪肝的发生有关。5、脂肪肝相关因素多因素非条件Logistic回归分析结果显示：年龄、超重、肥胖、经常吸烟、高胆固醇血症、高甘油三酯血症、高AST、高ALT等因素与脂肪肝的发生有关。结论：广西体检人群脂肪肝检出率较高。不同地方不同性别的脂肪肝检出率有差异,男性35~岁脂肪肝检出率最高,女性50~脂肪肝检出率最高。年龄越大,脂肪肝的检出率越高,中老年人是患脂肪肝的高危人群。肥胖、高血压、高血脂饮酒、吸烟、爱吃鱼和肉、口味偏咸可能增加脂肪肝的危险性。中度体力劳动、经常吃豆类及豆制品、多饮水可能降低脂肪肝的检出率。为控制脂肪肝,建议从控制体重、改善膳食等方面入手。
[Abstract]:Objective: to understand the prevalence of fatty liver and its related factors in Guangxi physical examination population, so as to provide a scientific basis for preventing and controlling the occurrence of fatty liver. Methods: 1 subjects: 5631 healthy volunteers from May 2014 to November 2015 by the examination center of the First Affiliated Hospital of Guangxi Medical University were selected from Nanning City, Guiping City, Rongxian County Province, 4 cities and counties part of the unit organization of collective examination as an object of study. 2, data collection methods: (1) epidemiological questionnaire: a unified designed epidemiological questionnaire was used to collect relevant information, including demographic data, dietary habits, work and exercise, mental health status. (2) physical examination: including height, weight, blood pressure, etc. (3) laboratory testing: including total cholesterol, triglycerides and glycosylated hemoglobin. (4) B ultrasound examination and electrocardiogram examination: including liver, bile, spleen, kidney and other abdominal examinations. 3, statistical methods: the epidemiological survey data, physical examination data and laboratory examination data were input by EpiData3.1 software, and database files were established. After consistency test, the data were converted to SPSS16.0 data files. First, descriptive analysis of data was made. Data were distributed normally, using mean + standard deviation (x + s), and counting data was described by rate or constituent ratio. The statistical inference based on statistical description, the difference of AST, UA, TG, HDL, LDL, red blood cell count and other biochemical indexes of fatty liver group and non fatty liver people were using two samples t test, factors of different levels of fatty liver detection hypothesis test rate difference by 2 test. Influencing factors of fatty liver disease by non conditional Logistic regression model analysis, univariate analysis significant factors included in the model analysis, the selection of the variables using the forward method, the test level is 0.05, statistically significant difference in P is less than or equal to 0.05. All statistical analysis was carried out using SPSS16.0 statistical software. Results: 1. Generally speaking, 5631 subjects were examined, 2702 in Nanning, 47.98%, 2240 in Guiping, 39.98%, 374 in Rongxian County, 6.64% in Pingnan County and 5.59% in Pingnan County. 2968 men, 52.7% and 2663 women, accounting for 47.3%, and the male and female ratio of 1.11:1. The youngest is 20 years old, the oldest is 94 years old, 20-35 years old group 1654 people, account for 29.4%; 35~50 year old group 2090 people, account for 37.1%; 50~65 year old group 1247 person, 22.1%; 65 year old group above 640 person, occupy 640. 2, 5631 patients with fatty liver disease survey, 1808 patients with fatty liver, the detection rate was 32.2%. The standardized detection rates of fatty liver were 26.27%, 37.63%, 22.32%, 29.18%, respectively, from four areas of Nanning, Guiping, Rongxian County and Pingnan County. The difference was statistically significant (chi 2=145.1, P0.001). The detection rate of fatty liver in male was significantly higher than that of women (x 2=339.8, P0.01). Compared with young, middle-aged, middle-aged and old age groups, the difference in the detection rate of fatty liver was statistically significant (P0.001). 3, the prevalence of fatty liver is different at different levels of research. The detection rates of fatty liver in overweight and obesity groups are 50.65% and 80.2%, respectively, which are higher than those in normal weight population (13.19%) (P0.05). The detection rate of fatty liver in hypertensive people was 52.31%, which was higher than that of 21.37% (P0.05) of normal blood pressure group. Light, mild, moderate and severe physical labor intensity of fatty liver detection rates were 32.4%, 35.4%, 26.4%, 29% (P0.05). In the 4 cases of severe, insufficient, general and sufficient sleep condition, the detection rate of fatty liver was 26.5%, 30.5%, 35.7%, 34.3%. There was a significant difference in the detection rate of fatty liver among four sleep states (P0.005). The results showed that the prevalence of fatty liver in physical examination group was 26.7%, 33.7%, 36.6%, 41%, respectively. No significant difference was found in the 4 alcohol drinking cases. Occasionally, drinking, drinking and drinking regularly. The difference was statistically significant (P0.05). The prevalence of fatty liver was 28.4%, 35.4%, 37.8,%, and 41.3% (P0.05) in the 4 people who had never smoked, occasionally smoked, smoked, and smoked frequently. Meat and meat products less, more, many three cases of fatty liver intake rate were 31.4%, 33.4%, 37.4%, the difference was statistically significant (P0.05), fish and aquatic products do not eat, eat less, eat more fatty liver crowd detection rates were 21.5%, 29.4%, 34.4%. The detection rates of fatty liver of 4 kinds of salt were 29.9%, 37.2% and 40% for light, moderate, salty, and high salt, and the difference was statistically significant (P0.05). The detection rates of fatty liver in the people who did not eat, occasionally and regularly eat were 33.9%, 25% and 20.2%, respectively, and the difference was statistically significant (P0.05). The mean values of ALT, AST, UA, BUN, CR, TC, TG and other biochemical indexes in fatty liver group were all higher than those in non fatty liver group. The HDL in fatty liver group was lower than that in non fatty liver group, the difference was statistically significant (P0.05). 4, fatty liver related factors of single factor non conditional logistic regression analysis showed that gender, age, region, overweight and obesity, hypertension, smoking and drinking, smoking, regular smoking, and occasionally often eat fish, high salt diet, eat soy products, lack of sleep, moderate labor intensity, high blood fat, high uric acid, high blood sugar, high cholesterol and other factors related to the occurrence of fatty liver. 5, fatty liver related factors, multivariate Logistic regression analysis showed that age, overweight, obesity, frequent smoking, hypercholesterolemia, hypertriglyceridemia, high AST and high ALT were related to the occurrence of fatty liver. Conclusion: the detection rate of fatty liver in Guangxi physical examination population is high. There is a difference in the detection rate of fatty liver between different sexes in different places, male 35~ years old fatty liver
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R575.5

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