摘要
目的通过测定非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者颈动脉内-中膜厚度及斑块情况,评价其发生心血管事件的风险。方法115例NAFLD患者与135例对照者,分别测量颈动脉内-中膜厚度及斑块,并对血脂、血糖、体质指数等进行统计学分析。结果NAFLD患者的颈动脉内-中膜厚度明显高于对照组(0.80±0.23mm对0.57±0.19mmP<0.01),其斑块检出率(54.8%)明显高于对照组(17.0%)差异有统计学意义(P<0.01)。NAFLD患者的腰围、体质指数、低密度脂蛋白胆固醇、甘油三酯、空腹血糖、胰岛素抵抗指数、谷丙转氨酶、谷氨酸转肽酶均明显高于对照组(P<0.05或P<0.01)。Logistic回归分析显示,以颈动脉内-中膜厚度为应变量,先后入选的变量有脂肪肝(OR=5.6)、年龄(OR=4.9)。结论可以认为NAFLD患者具有发生心血管并发症的高风险,应及时进行临床干预。
Objective To evaluate carotid artery intima-media thickness and presence of plaques and to define determinants of vascular damage in patients with nonalcoholic fatty liver disease （NAFLD）. Methods One hundred fifteen cases with nonalcoholic fatty liver disease and 135 normal persons,without a prior diagnosis of diabetes ,hypertension ,and cardiovascular disease, matched for sex, age. B-mode ultrasound examination was used for evaluation of carotid intima-media thickness and presence of small plaques. Results A significant difference in mean values of intima-media thickness（0.80±0.23mm vs 0.57±0.19 mm P〈 0.01 ）and prevalence of plaques [63 （54.8%）and 23 （17.0%）,P〈0.01 ]was observed in nonalcoholic fatty liver disease patients and control group respectively. Waist circumference, body mass index ,low-density lipoprotein cholesterol, fasting glucose, triglycerides and HOMA-insulin resistance in NAFLD group were higher than control group（P〈0.05 and P〈0.01 ,respectively）. At multivariate logistic regression performed in the overall series of subjects,independent risk predictors of intima-meclia thickness were presence of fatty liver[odds ratio （OR）=5.6] ,age （OR=4.9）.Conclusions Patients with nonalcoholic fatty liver disease should be considered at high risk for cardiovascular event.
出处
《中华保健医学杂志》
2009年第5期365-367,共3页
Chinese Journal of Health Care and Medicine
关键词
非酒精性脂肪性肝病
颈动脉
胰岛素抵抗
Nonalcoholic fatty liver disease
Carotid artery
Insulin resistance
