Risk factors of nonalcoholic fatty liver disease with a normal visceral adipose tissue area
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摘要: 目的明确腹腔内脂肪面积(VAT)正常的非酒精性脂肪性肝病(NAFLD)的危险因素及其胰岛素抵抗(IR)状态。方法选取2017年6月-2018年5月福建医科大学附属泉州第一医院收集的45例VAT正常的NAFLD患者为观察组,另取同期27例VAT正常且非NAFLD者作为对照组。分别测定2组对象的VAT、腰围、空腹血糖(FBG)、空腹胰岛素(FINS)等指标,计算IR指数(HOMA-IR),并分析IR与腰围等指标的相关性。正态分布的计量资料2组间比较采用独立样本t检验,非正态分布者采用Mann-Whitney U检验,计数资料2组间比较采用χ2检验。正态分布的计量资料相关性比较采用Pearson相关分析,非正态分布者采用Spearman相关分析。危险因素分析采用logistic回归分析(向前法)。结果 VAT正常的NAFLD组IR水平较对照组高,HOMA-IR2组间差异有统计学意义[2. 66(1. 59~4. 06) vs 1. 84(1. 25~2. 47),Z=364. 000,P=0. 005]; IR与FBG、FINS、TG呈正相关,r值分别为0. 412、0...Abstract: Objective To investigate the risk factors and insulin resistance ( IR) of nonalcoholic fatty liver disease ( NAFLD) with a normal visceral adipose tissue ( VAT) area. Methods A total of 45 NAFLD persons with a normal VAT area who were admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2017 to May 2018 were enrolled as observation group, and 27 non-NAFLD patients with a normal VAT area were enrolled as control group. VAT area, waist circumference, fasting blood glucose ( FBG) , and fasting insulin ( FINS) were measured for both groups, homeostasis model assessment of insulin resistance ( HOMA-IR) was calculated, and the correlation of IR with the indices including waist circumference was analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation of normally and non-normally distributed continuous data. A forward logistic regression analysis was used to identify related risk factors. Results The NAFLD group had a significantly higher level of IR than the control group, and there was a significant difference in HOMA-IR between the two groups ( 2. 66 ( 1. 59-4. 06) vs 1. 84 ( 1. 25-2. 47) , Z = 364. 000, P = 0. 005) . IR was positively correlated with FBG ( r = 0. 412, P = 0. 005) , FINS ( r = 0. 789, P <0. 001) , and TG ( r = 0. 306, P = 0. 041) . IR was negatively correlated with HDL ( r =-9. 398, P = 0. 007) . The multivariate regression analysis showed that waist circumference was an independent risk factor for NAFLD with a normal VAT area ( regression coefficient = 0. 181, odds ratio = 1. 198, 95% confidence interval: 1. 099-1. 306, P < 0. 001) . Conclusion There is a certain degree of IR in NAFLD patients with a normal VAT, and waist circumference is an independent risk for NAFLD with a normal VAT.
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Key words:
- non-alcoholic fatty liver disease /
- intra-abdominal fat /
- risk factors
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