哈尔滨市机关职员非酒精性脂肪性肝病流行病学调查

目的 了解哈尔滨市机关职员非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的患病率及其主要危险因素.方法 采用自制调查问卷,对2010年10月～2011年7月到哈尔滨医科大学第一临床附属医院体检的哈尔滨市区机关职员进行拦截式访问调查,问卷内容包括一般情况、生活方式、饮食习惯、疾病既往史、血液学及生物化学检查结果等资料,分析NAFLD的危险因素.结果 哈尔滨市机关职员NAFLD患病率为49.4％.单因素分析显示,病例组和对照组在性别、婚姻、学历、午餐地点、是否按时就餐、是否常吃坚果、碳水化合物摄入量、油脂摄入量等26个变量上的差异均有统计学意义(均有P＜0.05).多因素非条件Logistic回归分析显示,女性(OR =0.349,95％ CI:0.217 ～0.561)、研究生及以上学历(OR=0.581,95％ CI:0.380 ～0.888)、常饮茶(OR=0.535,95％ CI:0.336～0.854)是NAFLD的保护因素；而腰围粗(OR=5.735,95％ CI:2.992 ～ 10.990)、午餐地点在外( OR=1.649,95％ CI:0.433～0.974)、谷丙转氨酶升高(OR=3.254,95％ CI:1.401～7.560)、高血压(OR=1.678,95％ CI:1.041～2.705)、高甘油三酯(OR=3.020,95％ CI:1.793～5.088)是NAFLD的危险因素.结论 哈尔滨市机关职员NAFLD的患病率高于目前国外及我国其他地区的报道,不良的饮食习惯和生活方式是影响NAFLD患病率的重要因素.

Epidemiology investigation on NAFLD of Harbin City staff

Objective To investigate the prevalence of nonalcoholic fatty liver disease （NAFLD） of Harbin City staff, and the influencing factors of NAFLD. Methods The staffs who came to the first affiliated hospital of Harbin medical university for healthy check-up were recruited from October 2010 to July 2011. After that, we conducted a hospitalbased case-control study in patients with NAFLD and controls without NAFLD. Results One-way analysis of variance found that the two groups were significantly different in gender, marrital status, education background, lunch site, dietary schedule, nut consumption, carbohydrate consumption, fat consumption and so on （ all P〈0. 05 ）. By non-conditional Lo- gistic stepwise regression analysis, 8 of 23 factors were used to construct a model, five of which were the risk factors and three were protective factors of NAFLD. Protective factors included female （ OR=0. 349, 95% CI：0. 217-0.561 ）, master degree or above （ OR = 0. 581, 95% CI：0. 380-0. 888）, regular tea drinking （ OR = 0. 535, 95% CI：0. 336-0. 854）. Thick waist （ OR=5. 735, 95% CI：2. 992-10.990）, lunch out （ OR= 1. 649, 95% CI：0. 433-0. 974）, elevated alanine transarninase （ALT） （ OR = 3. 254, 95% CI： 1. 401-7. 560）, hypertension （ OR = 1. 678, 95% CI： 1. 041-2. 705 ）, tri- glycerides （OR= 3. 020, 95% CI： 1. 793-5. 088） were risk factors. Conclusions Harbin authority staffs have higher prevalence of NAFLD than in other parts of our country, improper eating habits and lifestyle factors affecting the prevalence of NAFLD, and metabolic syndrome are closely related with NAFLD.