代谢综合征各组分与非酒精性脂肪肝发病风险的关系

摘要

[目的]分析基线代谢综合征(MS)及其各组分与新发非酒精性脂肪肝(NAFLD)的关系.[方法]研究对象选择每年定期在大连医科大学附属第二医院体检中心行健康体检者1 305例,取得2007年6月—2008年12月的基线资料.2011年3月—2011年12月随访复查,两次调查资料均完整者1 303人,选择基线调查时未患NAFLD的838人进行分析.以随访时是否为NALFD分为两组,对比两组基线时各代谢综合征组分的差异,采用多因素logistic回归分析影响NAFLD的因素.[结果]基线时有MS者新发NAFLD累计发生率45.98％,无MS者新发NAFLD累计发生率15.58％.在不同性别均可见有MS者新发NAFLD累计发生率显著高于无MS组(P＜0.05).新发NAFLD者基线的年龄、血压、血糖、尿酸、体质指数、总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平均显著高于非NAFLD组人群,高密度脂蛋白胆固醇水平明显低于非NAFLD组人群.随着基线时存在代谢异常的数量增多,新发NAFLD的累计发生率明显增多,差异有显著性意义(P＜0.01).Logistic回归分析显示,男性性别、高总胆固醇、高甘油三酯和超重/肥胖发生NAFLD的风险分别为2.51(95％ CI 1.63～3.86)、1.34(95％ CI 1.07～1.68)、1.57(95％CI 1.20～2.07)和1.37(95％ CI 1.27～1.47).[结论]男性、高TC血症、高TG血症和肥胖增加NAFLD的患病风险.%To analyze the relationship of metabolic syndrome (MS) and its components and the incidence of non-alcoholic fatty liver disease (NAFLD). [Method] In this prospective study, 1305 subjects who underwent health examinations at least once a year at medical center were enrolled. Baseline data was obtained from the health examination during June 2007 and December 2008. The follow - up survey was conducted between March 2011 and December 2011. Total 838 subjects without NAFLD during the baseline survey were grouped depends on the whether they are NAFLD at follow ?up survey or not. The components of MS were calculated and compared between two groups. Logistic regression wasrncalculated to assess relative risks of incident NAFLD. [Results] The accumulative incidence rate of NAFLD in those with MS at baseline was 45. 98% , which was higher than that in subjects without MS at baseline ( 15. 58% ). In NAFLD group, the levels of variables at baseline, which included age, blood pressure, fasting glucose, uric acid, BMI, TC, TG and LDL-rnC were higher than non - NAFLD group, the level of HDL - C at baseline was lower in NAFLD group. The accumulative incidence rate of NAFLD was increased with increasing the numbers of metabolic disorders at baseline ( P < 0. 01 ). Multiple logistic regression models showed that male (OR=2.51; 95% CI: 1.63 -3.86), total cholesterol ( OR = 1.34; 95% CI: 1.07-1.68), triglyceride (OR = 1.57; 95% CI: 1.20 -2.07) and body mass index( OR = 1. 37 ; 95% CI: 1.27-1.47) were risk factors of NAFLD. [Conclusions] Male, hypercholesterolemia, triglyceridemia and obesity were significant associated with an increased risk of NAFLD.