桂林市汉族体检人群非酒精性脂肪肝危险因素分析及与脂联素基因启动子区多态性研究

发布时间：2019-02-15 23:35

【摘要】：目的:了解桂林市汉族体检人群非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的患病率、分布特征及相关危险因素,探讨脂联素基因启动子区-11377C/G单核苷酸多态性与NAFLD的相关性。方法:采用整群抽样方法,选择6660名体检者为研究对象,进行横断面调查,内容涉及问卷调查,测量身高、体重、血压,检测丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、空腹血糖(fasting plasma glucose,FPG)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、尿酸(uric acid,UA)及肝脏超声检查,并计算体重指数(body mass index,BMI)。应用聚合酶链式反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)法检测260例研究对象(NAFLD组130例,对照组130例)的脂联素基因启动子区-11377C/G单核苷酸多态性。结果:(1)桂林市6660例汉族体检人群中,NAFLD患病粗率为19.1%,全国人口标化率为16.9%(男性24.8%,标化后23.4%;女性12.9%,标化后10.1%)。50岁之前男性NAFLD患病率显著高于女性,而70岁之后显著低于女性,男女性NAFLD患病率的年龄交叉点在50-69岁中老年阶段。(2)NAFLD患病率随BMI增加呈升高趋势,无论男性或女性,超重和肥胖组NAFLD患病率显著高于正常组(P0.01),且肥胖组NAFLD患病率显著高于超重组(P0.01)。(3)共检出NAFLD 1273例(男性862例,女性411例),同时选取年龄与性别相匹配的健康人群1273例(男性862例,女性411例)为对照组,分析两组临床资料。NAFLD组BMI、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、ALT、AST、FPG、TG、TC、LDL-C、UA水平均高于对照组(P0.01),HDL-C低于对照组(P0.01)。(4)Logistic回归分析显示:性别(男)、BMI、高血压、ALT、FPG、TG、LDL-C、UA均为NAFLD危险因素,HDL-C为NAFLD保护因素。(5)脂联素基因启动子区-11377C/G单核苷酸多态性分析:NAFLD组与对照组基因型(CC:59.2%vs 63.8%,CG:36.2%vs 30.8%,GG:4.6%vs 5.4%)和等位基因频率(C:77.3%vs 79.2%,G:22.7%vs 20.8%)分布差异均无统计学意义(P0.05)。两组脂联素基因-11377C/G不同基因型与临床变量比较,差异均无统计学意义(P0.05)。结论:(1)桂林市汉族体检人群中有相当比例个体患有NAFLD,并存在年轻化趋势,且NAFLD患病率随BMI增加呈升高趋势。(2)NAFLD人群与代谢综合征(metabolic syndrome,MS)各组分密切相关。(3)性别(男)、BMI、高血压、ALT、FPG、TG、LDL-C、UA均为NAFLD危险因素,HDL-C为NAFLD保护因素。(4)脂联素基因启动子区-11377C/G单核苷酸多态性与桂林市汉族体检人群NAFLD发病无明显相关性。
[Abstract]:Objective: to investigate the prevalence, distribution and risk factors of non-alcoholic fatty liver (nonalcoholic fatty liver disease,NAFLD) in Han nationality in Guilin, and to explore the relationship between 11377C/G single nucleotide polymorphism and NAFLD in the promoter region of adiponectin gene. Methods: a cross-sectional survey was carried out in 6660 subjects by cluster sampling, including questionnaire survey, measurement of height, weight, blood pressure, and detection of alanine aminotransferase (alanine aminotransferase,ALT). Aspartate aminotransferase (aspartate aminotransferase,AST), fasting blood glucose (fasting plasma glucose,FPG), triglyceride (triglyceride,TG), total cholesterol (total cholesterol,TC), high density lipoprotein cholesterol (high-density lipoprotein cholesterol,HDL-C), Low density lipoprotein cholesterol (low-density lipoprotein cholesterol,LDL-C), uric acid (uric acid,UA), liver ultrasound and body mass index (body mass index,BMI) were calculated. Polymerase chain reaction-restriction fragment length polymorphism (polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP) was used to detect the single nucleotide polymorphisms of adiponectin gene promoter region (11377C/G) in 260 subjects (NAFLD group, 130 cases, control group, 130 cases). Results: (1) in 6660 Han people in Guilin, the crude rate of NAFLD was 19.1%, and the standardized rate of population was 16.9% (male 24.8, 23.4% after standardization); The prevalence of NAFLD in males before the age of 50 was significantly higher than that in females, and after 70 years of age, it was significantly lower in males than in females. (2) the prevalence of NAFLD increased with the increase of BMI. The prevalence rate of NAFLD in overweight and obesity group was significantly higher than that in normal group (P0.01), regardless of whether male or female, the prevalence rate of NAFLD was significantly higher in overweight and obese group than in normal group (P0.01). The prevalence of NAFLD in obese group was significantly higher than that in overweight group (P0.01). (3). 1273 cases of NAFLD were detected (male 862, female 411), and 1273 healthy persons (male 862, female 411) matched age and sex were selected as control group. The levels of BMI, systolic blood pressure (systolic blood pressure,SBP), diastolic blood pressure (diastolic blood pressure,DBP) and ALT,AST,FPG,TG,TC,LDL-C,UA in NAFLD group were higher than those in control group (P0.01). HDL-C was lower than the control group (P0.01). (4) Logistic regression analysis showed that sex (male), BMI, hypertension, ALT,FPG,TG,LDL-C,UA were all NAFLD risk factors) (5) single nucleotide polymorphism analysis of adiponectin gene promoter region-11377C/G: CC:59.2%vs group and control group (CC:59.2%vs 63.8G: 36.2 vs 30.8). There was no significant difference in the distribution of GG:4.6%vs 5.4% and allele frequency (C:77.3%vs 79.2g: 22.7vs 20.8%) (P0.05). There was no significant difference in adiponectin gene 11377C/G genotypes and clinical variables between the two groups (P0.05). Conclusion: (1) there is a significant proportion of individuals with NAFLD, in Guilin Han population, and the prevalence rate of NAFLD increases with the increase of BMI. (2) NAFLD population and metabolic syndrome (metabolic syndrome,. (3) Sex (male), BMI, hypertension, ALT,FPG,TG,LDL-C,UA were all risk factors of NAFLD). (4) 11377C/G single nucleotide polymorphisms in the promoter region of adiponectin gene had no significant correlation with the incidence of NAFLD in healthy population of Han nationality in Guilin.
【学位授予单位】：桂林医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R575.5

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