代谢正常肥胖个体发生非酒精性脂肪性肝病的相关性研究

摘要

目的:探讨代谢正常肥胖(Metabolically healthy obese,MHO)个体与非酒精性脂肪性肝病(Nonalcoholic fatty liver disease,NAFLD)发生的相关性.方法:选择2006年4月～2010年1月来湖南省人民医院体检中心体检人群共4076例,排除过量饮酒者、乙肝标志物阳性者及相关资料不全者共2830例纳入本研究.其中1367例在1～3年后再次体检.记录受检者身高、体重、血压、血脂、空腹血糖、腹部B超结果.NAFLD采用2010年中华医学会肝病学分会诊断标准中影像学诊断定义,行腹部B超检查进行诊断.结果:1.我院体检人群中MHO合并NAFLD者占51.34％,明显高于正常对照组(P=0.000),MHO组发生NAFLD的OR值为19.967(95％CI,12.646-31.533；P=0.000).2.随访1～3年后,MHO中NAFLD发病率高于正常对照组(44.44％ vs 7.02％,OR=10.600,95％CI,4.873-23.058；P=0.000).结论:MHO个体合并NAFLD比例较正常对照者升高,MHO个体增加NAFLD患病风险.%Objective: To investigate the relation between metabolically healthy obese and nonalcoholic fatty liver disease. Methods: 4076 subjects were examined for routine health in People's Hospital of Hunan Province from April 2006 to January 2010,2830 individual were enrolled excluding those with hepatitis B viruses, excessive alcohol consumption and missing data. 1367 individual were followed up in 3 years. Data were collected of those individuals on body height, body weight, blood pressure, lipid profile and fast blood glucose. Diagnosis of NAFLD was made by B-ultrasound based on the criteria of Chinese Society of Hepatology of imaging diagnosis of NAFLD in 2010. Results: 1. The percentage of NAFLD in individuals with MHO was 51.34% in subjects with healthy examination in People's Hospital of Hunan Province, which was significantly higher than that in normal controls (P=0.000). The presence of MHO was associated with an increased risk of NAFLD (OR=19.967; 95%CI, 12.646-31.533, P=0.000). 2. Following up for 1 to 3 years, we found that the incidence of NAFLD in patients with MHO was significantly higher than that in normal controls (44.44% vs 7.02%, OR=10.600, 95% CI, 4.873-23.058, P=0.000). Conclusions: The percentage of NAFLD in individuals with MHO was significantly higher than that in normal controls, MHO may increase the risk of NAFLD.