非肥胖人群非酒精性脂肪性肝病代谢特征及危险因素分析

田甜; 胡文炜; 李雪; 李吉; 张丹; 李长政

doi:10.3969/j.issn.1001-5256.2020.06.024

非肥胖人群非酒精性脂肪性肝病代谢特征及危险因素分析

DOI: 10.3969/j.issn.1001-5256.2020.06.024

中国人民解放军火箭军特色医学中心消化内科

基金项目:

北京市科技计划课题(Z1511000040150070)；

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中图分类号: R575.5
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出版历程
- 出版日期: 2020-06-20

Metabolic characteristics of nonalcoholic fatty liver disease and related risk factors in non-obese population

Research funding:

摘要

摘要:
目的分析非肥胖人群非酒精性脂肪性肝病（NAFLD）代谢特征及危险因素。方法回顾性分析2013年7月-2019年4月在解放军火箭军特色医学中心体检中心接受健康体检人群12 125例。根据BMI分为非肥胖人群（BMI<25 kg/m2） 8528例及肥胖人群（BMI≥25 kg/m2） 3597例,再根据腹部彩超结果将非肥胖人群分为NAFLD组（n=1025）与非NAFLD组（n=7503）。所有NAFLD人群（n=3281）根据BMI纳入非肥胖-NAFLD亚组（n=1025）、肥胖-NAFLD亚组（n=2256）。收集资料包括性别、年龄、BMI、空腹血糖、尿酸、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血红蛋白水平。非正态分布的计量资料以M（P25～P75）表示,组间比较采用Mann-Whitney U检验。计数资料采用χ2检验。危险因素分析采用多因素logistic回归分析。结果 12 125例体检人群中,NAFLD检出率为27. 06%,非肥胖性NAFLD检出率为8. 45%,占非肥胖人群的12. 02%,在单因素分析的基础上进行多因素logist...
- 肥胖,腹部 /
- 非酒精性脂肪性肝病 /
- 代谢综合征X /
- 危险因素
Abstract:
Objective To investigate the metabolic characteristics of nonalcoholic fatty liver disease( NAFLD) and related risk factors in non-obese population. Methods A retrospective analysis were performed for 12 125 individuals who underwent physical examination in Physical Examination Center of PLA Rocket Force Characteristic Medical Center from July 2013 to April 2019. According to body mass index( BMI) < 25 kg/m2,these individuals were divided into non-obese group with 8528 individuals and obese group with 3597 individuals; according to the results of abdominal ultrasound,the non-obese group was further divided into NAFLD group with 1025 individuals and non-NAFLD group with 7503 individuals. According to BMI < 25 kg/m2,3281 individuals with NAFLD were divided into non-obese NAFLD subgroup with 1025 individuals and obese NAFLD group with 2256 individuals. Related clinical data were collected,including sex,age,BMI,fasting blood glucose,uric acid,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,and hemoglobin.Non-normally distributed continuous data were expressed as M( P25-P75),and the Mann-Whitney U test was used for comparison between groups; the chi-square test was used for comparison of categorical data between groups. A multivariate logistic regression analysis was performed to investigate risk factors. Results Among the 12 125 individuals who underwent the physical examination,the detection rate of NAFLD was 27. 06%,and the detection rate of non-obese NAFLD was 8. 45%,accounting for 12. 02% of the non-obese population.The multivariate logistic regression analysis,based on the univariate analysis,had a diagnostic accordance rate of 89%,and the results showed that the increase in age,BMI,fasting blood glucose,uric acid,triglyceride,low-density lipoprotein,and hemoglobin were independent risk factors for non-obese NAFLD( odds ratio [OR]= 1. 043,1. 716,1. 161,1. 004,1. 791,2. 587,and 1. 011,P < 0. 001,< 0. 001, = 0. 001,< 0. 001, < 0. 001, < 0. 001,and = 0. 011),suggesting that non-obese NAFLD had the strongest association with low-density lipoprotein and had no association with age,uric acid,and hemoglobin. Total cholesterol and high-density lipoprotein were non-susceptible factors for non-obese NAFLD( OR = 0. 521 and 0. 523,P = 0. 007 and 0. 024). Conclusion Non-obese NAFLD is closely associated with metabolic disorders,and further studies are needed to explore the association between serum cholesterol and non-obese NAFLD.
- obesity,abdominal /
- non-alcoholic fatty liver disease /
- metabolic syndrome X /
- risk factors

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参考文献(24)

[1] ANDRONESCU CI,PURCAREA MR,BABES PA. Nonalcoholic fatty liver disease:Epidemiology,pathogenesis and therapeutic implications[J]. J Med Life,2018,11(1):20-23.

[2] LI Z,XUE J,CHEN P,et al. Prevalence of nonalcoholic fatty liver disease in mainland of China:A meta-analysis of published studies[J]. J Gastroenterol Hepatol,2014,29(1):42-51.

[3] GONG S,SONG J,WANG L,et al. Hyperuricemia and risk of nonalcoholic fatty liver disease:A systematic review and meta-analysis[J]. Eur J Gastroenterol Hepatol,2016,28(2):132-138.

[4] YOUNOSSI ZM,GOLABI P,de AVILA L,et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes:A systematic review and meta-analysis[J]. J Hepatol,2019,71(4):793-801.

[5] LI CY,CHEN J,SHI XF. Associations of non-alcoholic fatty liver disease with prevalence,severity,and prognosis of coronary heart disease[J]. Acta Acad Med Sin,2019,41(2):156-161.(in Chinese)李晨怡，陈佳，施向凡．非酒精性脂肪性肝病与冠心病患病率和严重程度以及预后的相关性[J]．中国医学科学院学报，2019,41(2):156-161.

[6] PARK H,DAWWAS GK,LIU X,et al. Nonalcoholic fatty liver disease increases risk of incident advanced chronic kidney disease:A propensity-matched cohort study[J]. J Intern Med,2019,286(6):711-722.

[7] CHVEZ-TALAVERA O,HAAS J,GRZYCH G,et al. Bile acid alterations in nonalcoholic fatty liver disease,obesity,insulin resistance and type 2 diabetes:What do the human studies tell?[J]. Curr Opin Lipidol,2019,30(3):244-254.

[8] CHO HC. Prevalence and factors associated with nonalcoholic fatty liver disease in a nonobese Korean population[J]. Gut Liver,2016,10(1):117-125.

[9] NISHIOJI K,SUMIDA Y,KAMAGUCHI M,et al. Prevalence of and risk factors for non-alcoholic fatty liver disease in a nonobese Japanese population,2011-2012[J]. J Gastroenterol,2015,50(1):95-108.

[10] Chinese Society of Diabetes. Guidelines for the prevention and treatment of type 2 diabetes in China(2017 edition)[J].Chin J Diabetes,2018,10(1):4-67.(in Chinese)中华医学会糖尿病学分会．中国2型糖尿病防治指南(2017年版)[J]．中华糖尿病杂志，2018,10(1):4-67.

[11] National Workshop on Fatty Liver And Alcoholic Liver Disease,Chinese Society of Hepatology,Chinese Medical Association;Fatty Liver Expert Committee,Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease:A 2018 update[J]. J Clin Hepatol,2018,34(5):947-957.(in Chinese)中华医学会肝病学分会脂肪肝和酒精性肝病学组，中国医师协会脂肪性肝病专家委员会．非酒精性脂肪性肝病防治指南(2018年更新版)[J]．临床肝胆病杂志，2018,34(5):947-957.

[12] SHARMA M,MITNALA S,VISHNUBHOTLA RK,et al. The riddle of nonalcoholic fatty liver disease:Progression from nonalcoholic fatty liver to nonalcoholic steatohepatitis[J]. J Clin Exp Hepatol,2015,5(2):147-158.

[13] Chinese Society of Endocrinology,Chinese Medical Association. Consensus for diagnosis and treatment of nonalcoholic fatty liver diseases and metabolic disorders(2nd Edition)[J]. J Clin Hepatol,2018,34(10):2103-2108.(in Chinese)中华医学会内分泌学分会．非酒精性脂肪性肝病与相关代谢紊乱诊疗共识(第二版)[J]．临床肝胆病杂志，2018,34(10):2103-2108.

[14] VOS B,MORENO C,NAGY N,et al. Lean non-alcoholic fatty liver disease(lean-NAFLD):A major cause of cryptogenic liver disease[J]. Acta Gastroenterol Belg,2011,74(3):389-394.

[15] LIU ST,ZHAO WX. Research advances in the pathogenesis of nonalcoholic fatty liver disease-related hepatocellular carcinoma[J]. J Clin Hepatol,2019,35(7):1621-1625.(in Chinese)刘素彤，赵文霞．非酒精性脂肪性肝病相关肝细胞癌的发病机制[J]．临床肝胆病杂志，2019,35(7):1621-1625.

[16] HALDAR S,CHIA SC,HENRY CJ. Body composition in Asians and caucasians:Comparative analyses and influences on cardiometabolic outcomes[J]. Adv Food Nutr Res,2015,75:97-154.

[17] KUMAR R,MOHAN S. Non-alcoholic fatty liver disease in lean subjects:Characteristics and implications[J]. J Clin Transl Hepatol,2017,5(3):216-223.

[18] CHEN F,ESMAILI S,ROGERS GB,et al. Lean NAFLD:A distinct entity shaped by differential metabolic adaptation[J].Hepatology,2020,71(4):1213-1227.

[19] LAI Q,GIRALT A,LE MAY C,et al. E2F1 inhibits circulating cholesterol clearance by regulating pcsk9 expression in the liver[J]. JCI Insight,2017,2(10).

[20] WANG X,HU YY,FENG Q. Current status of research on mouse models of nonalcoholic fatty liver fibrosis[J]. J Clin Hepatol,2019,35(8):1865-1869.(in Chinese)王欣，胡义扬，冯琴．脂肪性肝纤维化小鼠模型研究现状[J]．临床肝胆病杂志，2019,35(8):1865-1869.

[21] MARCOLIN E,FORGIARINI LF,TIEPPO J,et al. Methionineand choline-deficient diet induces hepatic changes characteristic of non-alcoholic steatohepatitis[J]. Arq Gastroenterol,2011,48(1):72-79.

[22] GIRALT A,DENECHAUD PD,LOPEZ-MEJIA IC,et al. E2F1promotes hepatic gluconeogenesis and contributes to hyperglycemia during diabetes[J]. Mol Metab,2018,11:104-112.

[23] DENECHAUD PD,LOPEZ-MEJIA IC,GIRALT A,et al. E2F1mediates sustained lipogenesis and contributes to hepatic steatosis[J]. J Clin Invest,2016,126(1):137-150.

[24] LI C,GUO P,OKEKUNLE AP,et al. Lean non-alcoholic fatty liver disease patients had comparable total caloric,carbohydrate,protein,fat,iron,sleep duration and overtime work as obese non-alcoholic fatty liver disease patients[J]. J Gastroenterol Hepatol,2019,34(1):256-262.

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