摘要
目的探讨多种性激素与非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)风险之间的关系,为预防或治疗NAFLD提供依据。方法数据来源于2017―2018年和2021―2023年美国健康与营养调查数据库。使用瞬时弹性成像对研究对象进行NAFLD检测。收集血液样本并测量9种性激素。使用logistic回归分析模型和分位数g计算回归分析模型分析性激素与NAFLD的关联。结果与Q1组相比,总人群中Q4组的雄烯二酮(OR=0.773,95%CI:0.621~0.961)、雌二醇(OR=0.647,95%CI:0.514~0.813)、性激素结合球蛋白(OR=0.271,95%CI:0.215~0.340)、黄体酮(OR=0.787,95%CI:0.640~0.968)和睾酮(OR=0.543,95%CI:0.330~0.889)与NAFLD风险降低有关(均P<0.05);Q4组的促卵泡激素(OR=1.612,95%CI:1.215~2.143)和促黄体生成素(OR=1.293,95%CI:1.006~1.662)与NAFLD风险增加有关(均P<0.05)。分位数g计算回归分析结果显示,性激素混合暴露与NAFLD风险呈负关联。正向权重前两位是雌酮和促卵泡激素,负向权重前两位是性激素结合球蛋白和雌二醇。在男性中,睾酮与雌二醇的比值与NAFLD风险呈负相关(OR=0.531,95%CI:0.375~0.741,P<0.001);在女性中,未发现睾酮与雌二醇的比值与NAFLD风险有关(OR=1.060,95%CI:0.948~1.187,P=0.308),睾酮与雌二醇的比值与性别间交互效应有统计学意义(P<0.001)。结论总人群中较高的性激素结合球蛋白、雌二醇、黄体酮、雄烯二酮和睾酮与NAFLD风险降低有关;促卵泡激素和促黄体生成素则相反。睾酮与雌二醇的比值与NAFLD间的关联在男性中更强。
Objective To explore the relationship between sex hormones and the risk of nonalcoholic fatty liver disease(NAFLD)and to provide a new basis for its prevention and treatment.Methods Data were obtained from the National Health and Nutrition Examination Survey(NHANES)cycles of 2017-2018 and 2021-2023.NAFLD was identified using transient elastography,and nine sex hormones were quantified from blood samples.Logistic regression and qgcomp models were employed to analyze the association between sex hormones and NAFLD.Results Compared with the lowest quartile,the highest quartile levels ofandrostenedione(OR=0.773,95%CI:0.621-0.961),estradiol(OR=0.647,95%CI:0.514-0.813),sex hormone-binding globulin(0R=0.271,95%CI:0.2150.340),progesterone(0R=0.787,95%CI;0.640-0.968),and testosterone(0R=0.543,95%CI:0.330-0.889)were associated with a reduced risk of NAFLD in the overall population.In contrast,the highest quartile levels offollicle-stimulating hormone(OR=1.612,95%CI:1.215-2.143)and luteinizinghormone(OR=1.293,95%CI:1.006-1.662)were associated with an increased risk of NAFLD(all P<0.05).Qgcomp regression analysis indicated that mixed exposure to sex hormones was negatively associated with NAFLD risk.The top two positive weights were estrone and follicle-stimulating hormone,while the top two negative weights were SHBG and estradiol.In men,the testosterone-toestradiol ratio was negatively associated with NAFLD risk(OR=0.531,95%CI:0.375-0.741,P<0.001).In women,no significant association was observed between the testosterone-to-estradiol ratio and NAFLD risk(OR=1.060,95%CI:0.948-1.187,P=0.308).The interaction effect between sex and the testosterone-to-estradiol ratio was statistically significant(P<0.O01).Conclusions In the overall population,higher levels of SHBG,estradiol,progesterone,androstenedione,and testosterone are associated with a reduced risk of NAFLD,whereas follicle-stimulating hormone and luteinizing hormone show the opposite association.The association between the testosterone-to-estradiol ratio and NAFLD is stronger in men.
作者
曾凡东
叶磊
马洁
梁雅丽
朱玉
ZENG Fandong;YE Lei;MA Jie;LIANG Yali;ZHU Yu(Department of Epidemiology and Health Statistics,School of Public Health,Wannan Medical College,Wuhu 241002,China;Division of Occupational Health and Radiological Health Supervision,Wuhu Municipal Center for Disease Control and Prevention,Wuhu 241000,China;Department of Occupational and Environmental Health,School of Public Health,Wannan Medical College,Wuhu 241002,China)
出处
《中华疾病控制杂志》
北大核心
2026年第3期316-323,共8页
Chinese Journal of Disease Control & Prevention
基金
安徽省高等学校科学研究项目(自然科学类)(2024AH051939,2022AH051247)
皖南医学院科研基金(WYRCQD2023020)。
