比较腹部脂肪沉积和异位肝脏脂肪沉积对外周血管僵硬度的影响

发布时间：2018-06-25 17:50

本文选题：腹型肥胖 + 非酒精性脂肪肝　；参考：《第三军医大学学报》2015年06期

【摘要】：目的通过测定有非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的正常体质量人群和没有NAFLD的腹型肥胖人群的心-踝血管指数(cardio-ankle vascular index,CAVI),来比较腹部脂肪沉积和异位肝脏脂肪沉积对外周血管僵硬度的影响大小。方法选取2012年1-12月在我院体检中心进行健康体检的111 552名中国汉族成人。按体质指数(BMI)和腰围(WC)及是否有脂肪肝,分为正常体质量对照组(NW,n=23 599),没有脂肪肝的腹型肥胖组(OB,n=3 238)和有脂肪肝的正常体质量组(NAFLD-NW,n=1 161)。比较各组CAVI值的大小。并且采用回归分析模型逐步矫正了年龄、性别、血压、血脂、血糖、肝酶、肌酐等混杂因素后,分析腹型肥胖自身和NAFLD自身与CAVI值的关系。NAFLD采用彩色多普勒超声检测。CAVI值采用动脉硬化检测仪测量,CAVI8 m/s为动脉僵硬度升高。结果 NAFLD在正常体质量人群和肥胖人群的发生率分别为4.69%和66.08%。NW-NAFLD组的CAVI值比OB组的CAVI值显著升高[(8.12±1.16)vs(7.93±1.38),P0.01]。当把腹型肥胖自身和NAFLD自身各自纳入回归分析模型时,矫正混杂因素后腹型肥胖自身和NAFLD自身均各自与CAVI值显著相关。然而当把腹型肥胖自身和NAFLD自身同时纳入回归分析模型时,矫正混杂因素后NAFLD自身仍然与CAVI值显著相关,而腹型肥胖自身与CAVI值不再有显著相关性。并且回归分析显示NAFLD具有CAVI值升高风险的比值比(odds ratio,OR)均高于腹型肥胖的比值比。结论异位肝脏脂肪沉积者比腹部脂肪沉积者有更高的动脉硬化的风险,因此在体质量正常者人群中进行NAFLD的筛查有助于早期预防动脉硬化。
[Abstract]:Objective to compare the effects of abdominal fat deposition and ectopic liver fat deposition on peripheral blood by measuring the cardio-ankle vascular index (cardio-ankle vascular) of normal body mass population with nonalcoholic fatty liver disease and abdominal obesity without NAFLD. The effect of tube stiffness. Methods 111,552 Chinese Han Chinese adults who underwent physical examination in our hospital from January to December 2012 were selected. According to body mass index (BMI), waist circumference (WC) and fatty liver, they were divided into normal body mass control group (NWN) 23 599, abdominal obesity group without fatty liver (OBN) 3 238 and normal body mass group with fatty liver (NAFLD-NWN 1 161). The value of CAVI in each group was compared. The regression model was used to correct the mixed factors such as age, sex, blood pressure, blood lipid, blood glucose, liver enzyme, creatinine, etc. The relationship between abdominal obesity and NAFLD and CAVI value was analyzed. NAFLD was measured by color Doppler ultrasound. CAVI 8 m / s was measured by arteriosclerosis detector. Results the incidence of NAFLD in normal body mass population and obese population was 4.69% and 66.08%, respectively. The CAVI value of NW-NAFLD group was significantly higher than that of OB group [(8.12 卤1.16) vs (7.93 卤1.38) P 0.01]. When abdominal obesity and NAFLD were included in regression model, both abdominal obesity and NAFLD were significantly correlated with CAVI. However, when abdominal obesity itself and NAFLD itself were included in regression analysis model, NAFLD itself was still significantly correlated with CAVI value after adjusting for confounding factors, but abdominal obesity itself had no significant correlation with CAVI value. The results of regression analysis showed that NAFLD had a higher odds ratio of increased risk than that of abdominal obesity. Conclusion there is a higher risk of arteriosclerosis in patients with ectopic liver fat deposits than in those with abdominal fat deposits, so screening for NAFLD in normal subjects is helpful for early prevention of arteriosclerosis.
【作者单位】：重庆医科大学附属第一医院内分泌科;重庆医科大学附属第一医院体检中心;重庆医科大学卫生统计教研室;
【分类号】：R575.5

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