乌鲁木齐市体检人群非酒精性脂肪肝危险因素的研究

发布时间：2019-04-09 07:11

【摘要】：近年来,随着人们生活水平的不断提高,生活方式和饮食结构的变化,超声等影像技术的广泛应用,非酒精性脂肪性肝病(Nonalcoholic fatty liver disease, NAFLD)患病率逐年上升,其发病率仅次于病毒性肝炎,已成为发达国家第一大慢性肝病以及肝功能异常的首要病因。NAFLD发生与代谢综合征(MS)、Ⅱ型糖尿病、转氨酶异常、高龄、肝炎病毒感染史等密切相关,并与多种不良行为或嗜好关系密切。NAFLD患病率在不同生活习性的人群中亦有不同。NAFLD目前主要以预防为主,尚缺乏有效的治疗方法。新疆为多民族聚集区,不同民族具有其独特的遗传特性和生活行为方式。本研究旨在探讨乌鲁木齐市体检人群中不同民族NAFLD的患病情况,并进行危险因素的分析,为今后社区综合干预提供科学的理论依据。目的：期望通过本研究了解乌鲁木齐市体检人群中非酒精性脂肪肝的患病情况,并探讨少数民族地区非酒精性脂肪肝的危险因素,为采取针对性的预防和治疗措施提供科学理论依据。方法：对2013年1月～6月期间乌鲁木齐市某医院体检中心的体检人群进行流行病学调查,采用问卷调查、体格检查、生化检查、超声检查及心电图检查等测量结果,进行单因素分析及多因素非条件Logistic回归模型,并计算各研究因素与NAFLD的关联强度OR值及其95%可信区间,以P0.05差异有统计学意义。结果：调查乌鲁木齐市体检人群2503例,诊断NAFLD 490例,其中汉族387例,维吾尔族69例,回族25例,其他9例。有家族史者152例,有既往史者121例。单因素分析：男性非酒精性脂肪肝的患病率高于女性(x2＝15.89,P＝-0.000);不同族别NAFLD患病率有差异(x2=10.094,P=0.000)；有既往史者的NAFLD患病率较高(x2=13.49,P=0.000)；而是否有家族史与NAFLD患病率无关(x2=3.050,P＝0.087)。对研究对象进行身高、体重及体质指数(BMI)的比较发现,两组间身高差异有统计学意义(P0.05)；NAFLD组体重及体质指数明显高于非NAFLD组,差异有统计学意义(P0.05)；且两组体质指数分级结果显示,非NAFLD组人群为超重,而NAFLD组人群为肥胖,此差异有统计学意义(P0.05)。对研究对象的腰围、臀围及腰臀比进行比较发现,NAFLD组腰围及臀围明显大于非NAFLD组,且差异均有统计学意义(P0.05)；对腰臀比进行的比较未见统计学差异(P0.05)。多因素非条件Logistic回归分析发现,将单因素分析有统计学意义的12个变量(性别、年龄、家族史、既往史、身高、体重、空腹血糖等)带入Logistic回归模型,采用向前似然比法进行逐步多因素非条件Logistic回归分析。结果显示,年龄大、性别为男性、族别为汉族、有既往史、BMI增大、腰围增大均为非酒精性脂肪肝的危险因素。结论：1.乌鲁木齐市体检人群中NAFLD的患病率为19.58%。男性及女性的NAFLD患病率随着年龄增长而逐渐增高,不同性别、不同年龄的NAFLD患病率有统计学意义；2.超重、肥胖、既往史及族别与非酒精性脂肪肝的发病关系密切,腰臀围大、体重过重是诱发NAFLID的危险因素。应采取有效干预措施、科学控制体重、合理膳食、加强户外运动,积极治疗糖尿病、高血压、肝炎等代谢性疾病是降低人群非酒精性脂肪肝患病率的重要措施。
[Abstract]:In recent years, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing year by year with the increasing of people's living standard, and the prevalence of non-alcoholic fatty liver disease (NAFLD) is second only to viral hepatitis. Has become the first major chronic liver disease in developed countries and the primary cause of liver function abnormality. NAFLD is closely related to metabolic syndrome (MS), type II diabetes, abnormal transaminases, advanced age, and hepatitis virus infection, and is closely related to many bad behaviors or hobbies. The prevalence of NAFLD is also different among the population with different life habits. NAFLD is mainly focused on prevention first and lacks effective treatment methods. Xinjiang is a multi-ethnic group, and different peoples have their unique genetic characteristics and lifestyle behavior. The purpose of this study is to explore the prevalence of NAFLD in different ethnic groups in the physical examination population in Urumqi, and to analyze the risk factors and provide a scientific basis for the comprehensive intervention of the community in the future. Objective: To study the prevalence of non-alcoholic fatty liver in the physical examination of Urumqi, and to explore the risk factors of nonalcoholic fatty liver in ethnic minority areas, and to provide scientific basis for the prevention and treatment of non-alcoholic fatty liver. Methods: The epidemiological investigation of the physical examination population of a hospital in the city of Urumqi from January to June 2013 was carried out. The results of questionnaire, physical examination, biochemical examination, ultrasonic examination and electrocardiogram examination were used. A single factor analysis and a multi-factor non-conditional logistic regression model were performed, and the correlation intensity OR value of each study factor and the NAFLD and the 95% confidence interval were calculated. Results: There were 2503 cases of physical examination in Urumqi and 490 cases of NAFLD, of which 387 were Han,69 in Uygur,25 in the Hui and 9 in the other. There were 152 patients with family history and 121 patients with a history of history. Single factor analysis: The prevalence of non-alcoholic fatty liver in male was higher than that of female (x2 = 15.89, P =-0.000); the prevalence of NAFLD in different races was different (x2 = 10.094, P = 0.000); the prevalence of NAFLD with prior history was higher (x2 = 13.49, P = 0.000); and whether family history was independent of the prevalence of NAFLD (x2 = 3.050, P锛，

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