3278例健康体检人群脂肪性肝病的患病率及相关因素分析

目的：通过健康检查明确脂肪肝的患病率及临床特点,为科学防治脂肪肝提供流行病学依据。方法：抽取湖北省鄂州市中心医院近2年20周岁以上体检人员,采用B超诊断脂肪肝,测定体重指数、血压,空腹检测血糖、胆固醇、甘油三酯、尿酸及ALT等指标。结果：1男女各年龄段患病率比较,总患病率男性高于女性,50岁之前男女各年龄段比较差异有统计学意义,但50岁以后各年龄段男女发病率比较差异均无统计学意义。2男性患者40-69岁各年龄段与总患病率比较差异均有统计学意义,20~29岁年龄段患病率明显低于总发病率,差异有统计学意义。3女性患者50~69岁各年龄段与总患病率比较差异均有统计学意义,20~39岁的患病率均明显低于总计患病率,差异有统计学意义。4男女脂肪肝患病率在50岁之前均随年龄的增长而升高,且差异有统计学意义,但50岁之后的各年龄段患病率比较差异无统计学意义。5脂肪肝患者ALT升高、体重指数升高、高脂血症、高血糖症、高血压、高尿酸血症的发生率明显高于非脂肪肝组,两组比较,差异均具有统计学意义,其中体重超重者高达70.5%远远高于非脂肪肝组的12.6%。结论：通过体检人群检查揭示鄂州地区脂肪肝的患病率为23.0%,主要的相关临床表现有体重超重、高脂血症、高血糖症、高血压症、高尿酸血症。临床医生治疗脂肪肝时关键策略应是减轻体重和控制好上述可能造成重要脏器损害的危险因素。     

广东省顺德市容奇镇肥胖症及其相关疾病的流行病学调查

目的 调查广东省顺德市容奇镇肥胖症及其相关疾病的流行病学情况，并分析体重指数（BMI）、腰围及腰臀比与高血压的关系。方法 普查容奇镇15岁以上所有有户口的居民25680人，内容包括问卷，测定身高、体重、血压，对于≥40岁的被调查者还测定了腰围、臀围等。结果 1996年容奇镇15岁以上的人群中，BMI 23.0-24.9kg/m^2占13.4%(标化率，以下同）,25.0-29.9kg/m^2占8.9%，≥30kg/m^2占1.3%。随年龄增加，肥胖患病率增高，50－59岁组最高。40岁以上的人群中，腹型肥胖患病率为35.0%（以腰围为判断标准）和36.7%(以腰臀比为判断标准）。女性腹型肥胖患病率明显高于男性。高血压患者中更倾向于腹型肥胖。以高血压为状态变量，以BMI、腰围、腰臀比为测定变量，做受试者工作特征曲线（ROC曲线），并对曲线下面积两两比较，结果提示腰围、腰臀比对高血压诊断的特异性和敏感性明显优于BMI；腰围、腰臀比对高血压诊断的特异性和敏感性差异无显著性。结论 ≥40岁以上人群中腹型肥胖患病率较高，且女性高于男性。腰围、腰臀比对高血压诊断的特异性和敏感性明显优于BMI。     

上海市社区60岁以上人群脂肪肝患病率及危险因素的横断面研究

目的了解上海市社区60岁以上人群脂肪肝的患病率及危险因素。方法对闵行区梅陇社区7534名60岁以上人群定期体检,填写统一设计的调查表,内容包括:一般情况、实验室检查、B型超声检查结果等。结果其中女性4198名,男性3336名,女男之比为1.26:1,平均年龄(68.8±7.0)岁。经B型超声检出脂肪肝3074例,占40.80%。60岁以上老年人脂肪肝患病率随着年龄增加而呈下降趋势,患病率最高的年龄段为60～64岁,达到45.20%。80岁以下,女性患病率显著高于男性。脂肪肝组的体质指数(BMI)、腰围、腰臀比(WHR)、三酰甘油、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、ALT、γ-谷氨酸转肽酶(GGT)等指标显著高于非脂肪肝组,而高密度脂蛋白胆固醇(HDL-C)则低于非脂肪肝组。相比正常对照组,肥胖、中心性肥胖和高脂血症分别增加脂肪肝患病风险15.2倍、10.8倍和8.6倍(P<0.01)。多元回归分析发现,女性、BMI、SBP、三酰甘油、HDL-C、LDL-C、TC、ALT、GGT等9项指标与脂肪肝密切相关。结论上海市社区60～64岁人群脂肪肝患病率较高,与肥胖及脂代谢紊乱密切相关。     

脂肪肝患者肝功能与代谢异常相关性研究

目的探讨脂肪肝患者代谢异常与肝脏损伤程度的关系。方法资料来源于2006年5月至2008年12月安徽医科大学第一附属医院健康体检资料,将研究对象分为非脂肪肝组、脂肪肝丙氨酸转氨酶(ALT)正常组、脂肪肝ALT升高小于2倍上限组和脂肪肝ALT升高大于2倍上限组。分别比较其血糖、血脂、尿酸水平以及高血压、高血糖、高甘油三酯血症、高胆固醇血症和高尿酸血症的患病率差异。结果脂肪肝患者空腹血糖浓度随ALT升高而升高;尿酸浓度、高血压的患病率在不同ALT浓度组间差异无统计学意义;在血脂代谢方面,ALT异常的男性脂肪肝患者血甘油三酯和总胆固醇的浓度较ALT正常患者高,但ALT 2倍以上升高和2倍以下升高组间差异无统计学意义。ALT异常的女性患者血甘油三酯和总胆固醇浓度未见明显升高,且总胆固醇浓度在ALT升高大于2倍上限组出现了显著降低。结论脂肪肝患者肝功能损害程度与血糖密切相关,而与血甘油三酯、血胆固醇、血尿酸及高血压关系不大。     

唐山市体检人群脂肪肝患病率调查分析

目的探究唐山市体检人群脂肪肝患病率情况,以期为脂肪肝的预防和调治提供合理依据。方法采集2014年3月-2016年2月唐山市12 808例体检人群资料,其中脂肪肝有3540例。统计年龄、性别、BMI、空腹血糖(FBG)、TC、TG、LDL-C以及肝脏超声检查结果。计数资料组间比较采用χ2检验;计量资料组间比较采用t检验。结果 7151例男性体检者中脂肪肝2750例(38.46%),5657例女性体检者中脂肪肝790例(13.96%),男性与女性患病率比较差异有统计学意义(χ2=947.25,P0.01)。不同年龄段(18~29岁、30~39岁、40~49岁、≥50岁)男女间脂肪肝检出率比较差异均有统计学意义(χ2值分别为337.58、474.06、449.38、12.86,P值均0.01)。男性、女性在不同BMI[肥胖(BMI≥28)、超重(24≤BMI28)、正常(BMI24))]间脂肪肝的检出率比较差异有统计学意义(χ2值分别为1104.01、500.23,P值均0.01)。分别对肥胖(BMI≥28)、超重(24≤BMI28)、正常(BMI24)体检者中男性与女性脂肪肝检出率进行比较,差异均有统计学意义(χ2分别为71.24、87.97、323.84,P值均0.01)。男性、女性体检者中肥胖及超重人群脂肪肝检出率均显著高于正常人群(P值均0.01)。脂肪肝组与非脂肪肝组FPG、TC、TG、LDL-C比较,差异均有统计学意义(t值分别为17.482、13.698、22.133、27.334,P值均0.001)。男性体检者中,脂肪肝与非脂肪肝体检者间FPG、TC、TG、LDL-C水平比较,差异均有统计学意义(t值分别为11.288、8.652、11.671、20.118,P值均0.01);女性体检者中,脂肪肝与非脂肪肝体检者间FPG、TC、TG、LDL-C水平比较,差异均有统计学意义(t值分别为16.816、5.532、15.154、18.507,P值均0.01)。结论唐山市成人体检人群脂肪肝患病率为男性明显高于女性。导致脂肪肝的主要因素可能是超重或肥胖、高脂血症、糖代谢异常。     

沈阳市不同职业人群脂肪肝的流行现状分析

目的探讨不同职业人群脂肪肝的流行现状。方法纳入6992名健康体检者为研究对象,职业来源包括2家医院的医护人员、3家银行的职员、3个工厂的工人及机关干部,所有研究对象均接受彩超检查。结果 6992名研究对象中,其中男性3662例,女性3330例,男女之比为1.10∶1。年龄（18～92）岁,平均年龄（40.00±11.34）岁,男女之间年龄差异无统计学意义。超声检出脂肪肝1593例（22.8%）,经性别及年龄调整后沈阳市脂肪肝的患病率为21.2%,男性为18.4%,女性为4.4%,男女之间脂肪肝的患病率差异有统计学意义（χ2=667.88,P〈0.001）。不同职业脂肪肝的患病率经年龄及性别调整后相应为：医护人员为18.6%,银行职员为20.3%,机关干部为17.6%,工人为28.7%,工人组明显高于其他3组,差异有统计学意义。男性患者发病高峰在（30～49）岁（41.4%）,女性患者随着年龄的增长逐渐增长。多元回归分析显示：性别、年龄、体重指数BMI、腰围、收缩压、血脂异常、血尿酸、空腹血糖及职业与脂肪肝相关。结论沈阳市脂肪肝的发病率高于南方城市。工人脂肪肝的患病率显著高于医护人员、银行职员及机关干部。脂肪肝的发病率与性别、年龄、代谢综合征及职业相关。     

男女两性脂肪肝患病率随年龄变化的特征性分析

目的探讨石家庄市不同性别脂肪肝患病率随年龄的增长变化及其危险因素。方法选取2012年1月-2012年12月在某体检中心体检的健康体检者57 150名(男39 442名,女17 708名),通过年龄、性别分层后比较其患病率及其增长变化,通过单因素及二项Logistic回归分析探讨男女脂肪肝的危险因素。结果 B超检出脂肪肝共20 045例,总患病率35.1%,其中男性高于女性(41.7%vs 20.2%,χ2=2 491.00,P0.001),男性在26~34岁年龄段患病率增加最显著(2.1%/年),45~49岁年龄段达到高峰(49.9%);女性在45~59岁年龄段患病率显著增加,并于55~59年龄段达到高峰(1.75%/年,42.4%)。单因素分析显示年龄、体质量、体质量指数(BMI)、腰围、臀围、腰臀比、甘油三脂、总胆固醇、谷丙转氨酶、尿酸等在脂肪肝组明显高于非脂肪肝组(P0.01)。二项Logistic回归分析表明BMI、腰臀比、甘油三脂、谷丙转氨酶、尿酸均为男性女性脂肪肝患者的危险因素,但总胆固醇仅为男性脂肪肝患者的危险因素。结论男性人群在25~34岁年龄段脂肪肝患病率增长较快,女性人群在55~69岁年龄段脂肪肝患病率增长较快,在该年龄段实施预防能起到事半功倍的效果。     

江苏泰州地区公务员脂肪肝发病现状及常规血清学因素分析

目的分析江苏泰州地区公务员脂肪肝发病现状及常规血清学指标变化,为公务员脂肪肝的防治提供科学依据。方法对在我院体检的849名泰州地区公务员的脂肪肝患病率、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)结果进行统计分析。结果脂肪肝的总患病率为39.1%,男性为50.1%,女性为22.6%,差异有统计学意义(P=0.000);患病率男性在各年龄组差异无统计学意义(t=0.069,P=0.966),女性随着年龄的增加呈增高趋势(t=16.357,P=0.000),差异有统计学意义;脂肪肝组在年龄、ALT、AST、AKP、GGT、TG、TC、FBG,均高于非脂肪肝组,差异有统计学意义(均P=0.000)。逐步回归分析提示TG、ALT、FBG是脂肪肝发病的危险因素。结论江苏泰州地区公务员脂肪肝的患病率较高,TG、ALT、FBG异常是其发病的危险因素。     

江门市新会区脂肪肝的流行病学调查及危险因素分析

目的研究脂肪肝在江门市新会区成人中的流行趋势、现状与危险因素。方法对3483各类体检人员的健康咨询、体格检查、空腹血糖、肝功能、血脂等指标及肝脏B超检查结果进行回顾性分析。结果江门市新会区体检人员中检出脂肪肝769例（22．08％），经年龄和性别调整后，新会区成人脂肪肝患病率21．57％。酒精性脂肪肝、可疑酒精性脂肪肝、非酒精性脂肪肝患病率分别为0．86％、0．69％、20．02％。脂肪肝患病率均随年龄增长而增加，60岁之前男性脂肪肝患病率显著高于女性．而60岁以后男女脂肪肝患病率相当。单因素分析显示，脂肪肝组年龄、体重指数、腰围、舒张压、空腹血糖、甘油三酯、胆固醇、丙氨酸氨基转移酶均显著高于非脂肪肝组（P〈0．001）。多元回归分析显示：甘油三酯、腰围、空腹血糖、BMI、舒张压、丙氨酸氨基转移酶、年龄和性别（男性）等指标与脂肪肝密切相关。结论江门市新会区成人脂肪肝患病率高，主要为非酒精性脂肪肝。脂肪肝发病率男性明显高于女性。高脂血症、超重及肥胖、糖代谢紊乱、高血压、高丙氨酸氨基转移酶、年龄、男性等为脂肪肝危险因素。     

上海市成人脂肪肝患病率及其危险因素流行病学调查

目的 明确上海市成人脂肪肝的患病率及其主要危险因素。 方法 通过随机多级分层整群抽样对杨浦区和浦东新区各4个居委会16岁以上居民进行调查,内容涉及问卷咨询、体格检查、75 g葡萄糖耐量试验、血脂检测、以及肝脏实时超声检查。 结果 3175名成人完成调查,约占上海市人口的2.26／10000。其中男性1218名,女性1957名,平均年龄(52.4±15.1)岁。B超共检出脂肪肝661例,占20.82％,其中酒精性、可疑酒精性、非酒精性脂肪肝分别占3.48％、4.08％及92.43％。经年龄和性别调整后,上海市成人脂肪肝患病率为17.29％,酒精性脂肪肝、可疑酒精性脂肪肝、非酒精性脂肪肝患病率分别为0.79％、1.15％、15.35％。无论是男性还是女性,脂肪肝患病率均随年龄增长而增加,50岁之前男性脂肪肝患病率显著高于女性(x2=13.934,P<0.01),而50岁以后女性脂肪肝患病率显著高于男性(x2=4.146,P<0.05)。脂肪肝组年龄、体重指数(BMI)、腰围、血压、空腹及餐后血糖、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、肥胖、糖尿病、高血压病、血脂异常和胆石症患病率等均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)水平以及文化程度显著低于对照组。多元回归分析显示:男性、文化程度、腰围、BMI、HDL-C、TG、空腹血糖水平、糖尿病、     

High prevalence of elevated liver enzymes in blood donors: associations with male gender and central adiposity

OBJECTIVE: Nonalcoholic fatty liver disease is an increasingly recognized condition, but its exact prevalence is unknown. In this prospective, multicenter study, we evaluated the prevalence of elevated alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl-transpeptidase levels as indirect markers of nonalcoholic fatty liver disease in volunteer blood donors as well as their associations with epidemiological and anthropometrical characteristics. METHODS: Alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl-transpeptidase levels were determined in blood donors from four transfusion centers during the morning sessions of a 3-month period. Cases with positive hepatitis B surface antigen, anti-hepatitis C virus, anti-HIV or elevated liver enzymes and alcohol abuse were excluded. RESULTS: Abnormal liver enzymes were found in 17.6% of 3063 participants (alanine aminotransferase: 14.5%, aspartate aminotransferase: 4.6%, gamma-glutamyl-transpeptidase: 4.7%). Individuals with abnormal compared with those with normal liver enzymes or alanine aminotransferase values were more frequently men and had higher weight, body mass index, waist, hip and neck circumference (P<0.001 for all comparisons). The prevalence of abnormal liver enzymes was also associated with the transfusion center ranging between 8.8 and 22.1% (P<0.001) and alcohol consumption (P=0.001). In multivariate analysis, presence of elevated enzymes was independently associated with male sex, higher weight or body mass index, higher waist circumference and transfusion center. CONCLUSIONS: More than 15% of Greek blood donors exhibit elevated liver enzymes, most likely as a result of unrecognized nonalcoholic fatty liver disease. The prevalence of nonalcoholic fatty liver disease is mainly associated with male sex, obesity and waist circumference, but it may range significantly among different population groups.     

胰岛素抵抗与2型糖尿病合并非酒精性脂肪肝关系的研究

研究胰岛素抵抗与2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFL）的关系,发现T2DM伴有脂肪肝组BMI、WHR、TC、TG、血尿酸、丙氨酸氨基转移酶、γ-谷氨酰转移酶和HOMA-IR较T2DM不伴脂肪肝组升高（P均〈0．01）;Logistic回归分析表明,HOMA—IR、TC、TG、WHR是NAFL形成的独立危险因素。     

Prevalence of nonalcoholic fatty liver among administrative officers in Shanghai： an epidemiological survey

AIM: To determine the prevalence of nonalcoholic fatty liver in a specific population in Shanghai by an epidemiological survey, and to analyze risk factors of fatty liver.METHODS: Total 4009 administrative officers who denied regular alcohol drinking participated in the survey, and underwent physical examination and laboratory tests. The important parameters were body mass index (BMI), waist hip circumferences ratio (WHR) and levels of serum lipids.Diagnosis of fatty liver was based on established real-time ultrasonographic criteria, the presence of an ultrasonographic pattern consistent with “bright liver”, with evident ultrasonographic contrast between hepatic and renal parenchyma, vessel blurring, and narrowing of the lumen of the hepatic veins. Analysis of data was performed through SPSS for Windows statistical package.RESULTS: The overall prevalence of fatty liver was 12.9%,15.8% in males and 7.5% in females, and the prevalence of fatty liver in males younger than 50 years old, was significantly higher (13.3%) than that of in females (2.7%).But the difference between the sexes became less significant in people older than 50 years (19.1% vs 18.1%). Theprevalence of fatty liver was increased with age; this was markedly presented in females younger than 50 years.Multiple variant regression analysis demonstrated that the prevalence of fatty liver was positively correlated to several risk factors, including male, aging (&gt;50yr), hyperlipidemia,impaired glucose tolerance/diabetes mellitus, hypertension and overweight/obesity.CONCLUSION: There is a high prevalence of nonalcoholic fatty liver among certain population in Shanghai, to which overweight and hyperlipidemia are closely relevant.     

Are there any sex differences in fatty liver? A study of glucose metabolism and body fat distribution

BACKGROUND AND AIMS: Fatty liver is a common condition found more often in males. Whether sex differences affect its development is presently unknown. The hypothesis that glucose metabolism alterations or central body fat distribution are gender-related in fatty liver was investigated. METHODS: Overall 199 consecutive subjects seen in the Division of Internal Medicine and Gastroenterology, Modena City Hospital, were enrolled. In the main arm of the present study, 44 men with sonographic fatty liver and 47 controls without, and 18 women with and 19 without fatty liver had their body mass index (an index of overall adiposity), hepatobiliary serum enzymes, serum cholesterol and triglycerides determined. All underwent oral glucose tolerance tests (estimated through the glucose area under the curve with the trapezoidal method). In the ancillary arm study, 17 other men with and 14 without, and 11 other women with and 29 without fatty liver had anthropometric measurements of body fat distribution (waist/hip, waist/height and skinfold thickness). RESULTS: Following statistical evaluation including univariate and multivariate analyses (main study), elevated body mass index was found to be an independent predictor of fatty liver in either sex. Glucose area under the curve and a central-type body fat distribution (ancillary study) predicted FL only in women. CONCLUSIONS: Fatty liver could be gender-related in the present series.     

减体重对肥胖和超重者心血管病危险因素的影响

目的：探讨对肥胖和超重者的减肥对心血管危险因素的影响。方法：对41名肥胖和超重者采取6周封闭管理的集中减肥，控制饮食，进行运动训练，每2周测定体重、腰臀围等指标，减肥前、后进行空腹血脂、血糖、血胰岛素、血转氨酶及肝脏超声检查。结果：通过6周减肥，受试者的体重、体重指数、腰围、臀围、腰臀围比、皮褶厚度、体脂含量及百分比、静息血压、心率呈非常明显的下降（P〈0．001）：减肥后血丙氨酸氨基转移酶、甘油三酯、胰岛素及胰岛素抵抗指数明显下降（P〈0．05-〈0．001），血高密度脂蛋白-胆固醇明显升高（P〈0．001），脂肪肝显著改善（P=0．001）。结论：运动锻炼结合饮食控制可减轻肥胖和超重者的体重，有效降低心血管疾病的危险因素。     

Prevalence of fatty liver disease and its risk factors in the population of South China

AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province,China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province,China. Questionnaires,designed by co-working of epidemiologists and hepatologists,included demographic characteristics,current medication use,medical history and health-relevant behaviors,i.e. alcohol consumption,smoking habits,dietary habits and physical activities. Anthropometric measurements,biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects,609 (17.2%) were diagnosed having FLD (18.0% males,16.7% females,P > 0.05). Among them,the prevalence of confirmed alcoholic liver disease (ALD),suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%,1.8%,and 15.0%,respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age,gender and residency,the standardized prevalence of FLD in adults was 14.5%. Among them,confirmed ALD,suspected ALD and NAFLD were 0.5%,2.3%,and 11.7%,respectively,in adults and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%,P < 0.001). However,the opposite phenomenon was found over the age of 50 years (20.6% vs 27.6%,P < 0.05). Multivariate and logistic regression analysis indicated that male gender,urban residency,low education,high blood pressure,body mass index,waist circumference,waist to hip ratio,serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD,especially NAFLD,is prevalent in South China. There are many risk factors for FLD.     

Evaluation of the burden of type 2 diabetes mellitus in population of Puducherry,South India

AimsTo find out the prevalence of undiagnosed diabetes mellitus and the correlates among the adult population of Puducherry, South India.MethodsIn this population based cross-sectional study in the rural and urban field practice area of Mahatma Gandhi Medical College and Research Institute, Puducherry, by simple random sampling 1013 adults of 30 years and above, not on anti-diabetics drugs were included. Main outcome measures were the prevalence and correlates of undiagnosed diabetes mellitus among the adult population. Pre-designed and pre-tested questionnaire was used to elicit the information on family and individual socio-demographic variables. Height, weight, waist and hip circumference, blood pressure were measured and venous blood was collected to measure fasting blood glucose and blood cholesterol.ResultsOverall, 10.3% study subjects were diagnosed as diabetic. In univariate analysis age, dilatory habit, tobacco addiction, body mass index, waist hip ratio, hypertension, and total blood cholesterol were found statistically significant. In multivariate logistic regression (LR method) analysis age, residence, education, dietary habit, tobacco addiction, body mass index, waist hip ratio and total blood cholesterol were statistically significant.ConclusionsIn our study adults having increased age, urban residence, illiterate, non-vegetarian diet, tobacco addiction, obese and high total blood cholesterol were important correlates.