目的 研究非酒精性脂肪性肝病(NAFLD)严重程度与腹腔内脂肪面积(VAT)、身体质量指数(BMI)及腰围(WC)的相关性.方法 127例NAFLD病例,根据彩超脂肪变严重程度分为轻、中、重三组,其中轻度61例、中度45例、重度21例,选择21例同期就诊的非脂肪肝患者作为对照.所有研究对象均由专人测量身高、体重、WC,接受肝脏超声波检查及肝功能等检测,并接受腹部CT扫描,测量VAT、腹壁皮下脂肪面积(SAT)、腹部脂肪总面积(TA).计量资料呈正态分布且方差齐性者以单因素方差分析比较组间差异,方差不齐者以ANOVA(Welch法)比较,否则改用非参数检验(Kruskal-Wallis H检验).计数资料采用x2检验进行组间比较.组间比较差异有统计学意义者再行两两比较.双变量正态分布资料采用Pearson相关分析,不服从双变量正态分布或等级变量资料相关性采用Spearman相关分析.结果 各组年龄、性别差异无统计学意义(P均＞0.05),各组WC、VAT、TA、SAT、BMI、AST、ALT、GGT差异有统计学意义(P均＜0.05).NAFLD严重程度与BMI、WC、VAT、SAT、TA呈显著正相关,r分别为0.467(P=0.000)、0.503(P =0.000)、0.473(P=0.000)、0.280(P =0.001)、0.465 (P =0.000).结论 控制体重,尤其是中心性肥胖者,是预防NAFLD的重要措施之一.%Objective To analvze the correlation of the severity of non-alcoholic fatty liver disease (NAFLD) with visceral adipose tissue area (VAT),body mass index (BMI),and waist circumference (WC).Methods A total of 127 NAFLD patients were divided into mild NAFLD group (n =61),moderate NAFLD group (n =45),and severe NAFLD group (n =21) according to the severity of hepatic steatosis evaluated by color Doppler ultrasound; 21 patients without NAFLD who visited the hospital during the same period were selected as a control group.All subjects were examined by special professionals to measure the body height,body weight,and WC,underwent liver ultrasound and liver function test,and received abdominal CT scans to determine VAT,abdominal subcutaneous adipose tissue area (SAT),and total abdominal adipose tissue area (TA).For comparison of normally distributed measurement data among groups,one-way analysis of variance (ANOVA) was used if the variances were equal,and Welch ANOVA was used if the variances were unequal ; for comparison of other measurement data among groups,nonparametric test (Kruskal-Wallis H test) was used.Chi-square test was used for comparison of numeration data among groups.Pairwise comparison was performed for each variable with a statistically significant difference among groups.Pearson correlation coefficient was used for correlation analysis of data with a bivariate normal distribution,while Spearman correlation coefficient was used for correlation analysis of data without a bivariate normal distribution or ranked data.Results There were no significant differences in age and sex among the groups (P ＞0.05 for all comparisons),but there were significant differences in WC,VAT,TA,SAT,BMI,aspartate aminotransferase,alanine aminotransferase,and gamma-glutamyl transpeptidase (P ＜ 0.05 for all comparisons).The severity of NAFLD was positively correlated with BMI,WC,VAT,SAT,and TA (r =0.467,P =0.000; r =0.503,P =0.000; r =0.473,P =0.000; r =0.280,P =0.001 ;r =0.465,P =0.000).Conclusion Control of body weight,especially for patients with central obesity,is one of the most important measures to prevent NAFLD.
展开▼
