摘要
目的观察非酒精性脂肪性肝病(NAFLD)在不同血尿酸水平人群中的分布,探讨血尿酸水平与NAFLD的相关性。方法以云南省第三人民医院体检中心10 460例健康体检者为研究对象,测量其身高、体质量、血压,空腹采血检测肝肾功能、血脂、血糖、肝炎病毒学相关指标,同时行心电图、腹部超声、胸部X线等检查。NAFLD诊断依据2010年中华肝脏病学会和酒精性肝病学组规定的NAFLD诊断标准。结果除高血糖人群外,随血尿酸水平增高,男性和女性超重或肥胖、高血压、血脂异常以及代谢综合征(MS)检出率均逐步升高(P<0.05)。除男性MS人群外,无论有无超重或肥胖、高血糖、高血压、血脂紊乱,NAFLD检出率均随血尿酸水平增高而明显升高,尤其当血尿酸水平>333μmol/L(男)或>233μmol/L(女)时(P<0.05),且女性高血糖和血脂紊乱人群、最低尿酸水平组人群NAFLD的检出率较高(P<0.05)。对无任何MS相关组分的人群研究发现,在相同血尿酸水平下,男性NAFLD检出率明显高于女性(P<0.01),女性NAFLD检出率在血尿酸>233μmol/L时迅速升高(P<0.01);无论男女NAFLD检出率均随血尿酸水平增高而增高(P<0.05);Logistic回归分析显示,性别、体质指数、血糖、三酰甘油、低密度脂蛋白胆固醇、尿酸分级是NAFLD的高危因素,OR值分别为2.600、1.354、1.282、1.276、1.214和1.236。结论高尿酸血症是NAFLD的高危因素,与NAFLD的发病密切相关。
Objective To analyze the relationship between serum uric acid and nonalcoholic fatty liver disease （NAFLD） by observing the prevalence of NAFLD among population with different levels of serum uric acid. Methods Totally 10 460 individuals who received health check - up in our center were enrolled. Their body height, weight, blood pressure, hep-atitis related markers, blood lipids, blood sugar, and liver and kidney function in the fasting state were measured, andelectro- cardiograghy, abdominal color Doppler ultrasound, and chest X - ray examination were performed. The diagnosis of NAFLD was made according to the diagnostic criteria developed by China Institute of Liver Disease and Alcoholic Liver Disease Group. Re-suits Except in hyperglycemic individuals, the incidences of overweight/obesity, hypertension, hyperlipidemia, and metabolic syndrome （MS） increased along with the rise of serum uric acid （ P 〈 0.05 ）. Except in male MS patients, the incidence of NAFLD also rose no matter whether the subjects had overweight/obesity, hyperglycemia, hypertension, or lipids disorder, espe-cially when serum uric acid level was higher than 333 μmol/L in males or higher than 233 μmol/L in females （ P 〈 0. 05 ）. The incidence of NAFLD was expecially high among female subjects with hyperglycemia and lipids disorder and those with the lowest level of serum uric acid （P 〈 0. 05 ）. Among subjects without any metabolic syndrome, the detection rate of NAFLD was signifi-cantly higher in males than in females at the same serum uric acid level, but there was a sharp rise of NAFLD incidence among fe- males when the serum uric acid was greater than 233 μmol/L （ P 〈 0. 01 ） ; meanwhile, the detection rate of NAFLD increased with the rise of serum uric acid in both males and females （P 〈 0. 05）. Logistic regression analysis showed that sex, body massindex, blood glucose, triglyceride, low - density lipoprotein cholesterol, and uric acid grading were risk factors for NAFLD （ OR = 2. 600, 1. 354, 1. 282, 1. 276, 1. 214, 1. 236 respectively）. Conclusion Hyperuricemia is the high risk factor for NAFLD.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第8期844-847,共4页
Chinese General Practice
关键词
脂肪肝
非酒精性
高尿酸血症
横断面研究
Fatty liver, nonalcoholic
Hyperuricemia
Cross - sectional studies
