男性代谢综合征及其组分与非酒精性脂肪肝病关系研究

目的 探讨男性代谢综合征(MS)及其组分与非酒精性脂肪肝病(NAFLD)的关系.方法 用横断面研究的方法对1902例研究对象进行分析,根据NAFLD的诊断标准分为NAFLD组(778例)和对照组(1 124例).测定2组人群血压、BMI、TC、TG、LDL-C、HDL-C、空腹血糖和餐后2h血糖(2 h PG)、尿酸等指标并进行比较.结果 本组男性资料NAFLD的患病率为40.9％ (778/1902)；男性人群NAFLD组的BMI、高血压患病率、TG、空腹血糖及2hPG、LDL-C、尿酸水平均高于对照组[(25.6±2.1)kg/m2比(23.7± 5.6) kg/m2,33.8％ (263/778)比21.3％ (239/1124),(2.2±1.4) mmol/L比(1.4±0.8)mmol/L,(8.2±2.5) mmol/L比(7.2±1.7) mmol/L,(2.8±0.7)mmol/L比(2.7±0.7) mmol/L,(425±85) μmol./L比(336±100).μmol/L,P＜0.01],HDL-C水平低于对照组[(1.27±0.28) mmol/L比(1.44±0.34) mmol/L,P＜0.01]；Logistic回归分析显示TG、HDL-C、2 h PG、尿酸、BMI、高血压[OR值(95％ CI)分别为1.6559(1.253～2.026)、0.303(0.1526 ～0.603)、1.205(1.100 ～1.320)、1.003(1.001 ～ 1.005)、1.160(1.069～1.259)、1.69(1.084～2.634),均P＜0.05]是男性NAFLD的独立危险因素；与对照组相比,NAFLD组患者伴有2个以上MS组分者增多,差异有统计学意义(P＜0.05),男性MS在NAFLD组患病率明显高于对照组[41.7％(324/778)比13.7％(154/1124),P＜0.05]；男性MS患者发生NAFLD病的相对危险性是无MS患者的4.48倍(95％ CI,3.0786 ～6.5281).结论 男性人群NAFLD与多元代谢紊乱存在密切关系；MS组分TG、HDL-C、2 h PG、BMI、高血压是男性NAFLD病的独立危险因素.男性MS发生NAFLD的相对风险明显升高.

Association of non-alcoholic fatty liver disease with metabolic syndrome and its components

Objective To explore the association of non-alcoholic fatty liver disease （NAFLD） with meta- bolic syndrome（MS） and its components in male. Methods A cross-sectional study on 1902 subjects who were di- vided into NAFLD group （n = 778 ） and control group（ n = 1124） by the diagnosis standants of NAFLD. Blood pres- sure, body mass index（ BMI）, total cholesterol（TC）, triglyceride（TG）, low density lipoprotein cholestrol（ LDL-C）, high density lipoprotein cholestrol （ HDL-C）, fasting and postprandial plasma glucose （ FPG, 2 h PG） as well as blood uric acid（UA） were measured. Results The prevalence of NAFLD in male group was 40.9%. BMI, the presence of hypertension, TG, FPG, 2 h PG, UA in male group were significantly higher in NAFLD group than in control group [ （25.6 ± 2. 1 ） kg/m2 vs （23.7 ± 5.6） kg/m2, 33.8% （263/778） vs 21.3% （239/1124）, （ 2.2 ± 1.4） mmol/L vs （ 1.4 ± 0.8 ） mmol/L, （ 8.2 ± 2.5 ） mmol/L vs （7.2 ± 1.7 ） mmol/L, （2.8 ± 0.7 ） mmol/L vs （ 2.7 ± 0.7 ） mmol/L, （425 ± 85 ）/xmol/L vs （336 ± 100）/xmol/L, P 〈 0.01 ]. HDL-C was lower in NAFLD group [ （ 1.27 ± O. 28） mmol/L vs （ 1.44 ± O. 34） mmol/L, P 〈 0.01 ]. Logistic regression analysis showed that the level of TG,HDL-C, 2 h PG, UA, BM! and the presence of hypertension[ odds ratios（95% CI）were 1. 6559（ 1. 253- 2.026）, 0.303（0.1526-0.603）, 1.205（1. 100-1.320）, 1.003（1.001-1.005）, 1. 160（1. 069-1.259）, 1.69 （ 1. 084-2. 634） respectively ; all P 〈 0.05 ] were independent risk factors of NAFLD group ; Compared with the control group more than two numbers of MS components were increased in NAFLD group. The prevalence of MS in male group was higher than in control group（41.7% vs 13.7% ,P 〈 0.05 ）. The relative risk （ RR = 4.48, 95% CI 3. 0786-6. 5281 ） for NAFLD group significantly increased in patients with MS in male group. Conclusions In male groups NAFLD is closely related with cluster metabolic disorders. The level of TG, HDL-C, 2 h PG, BMI and the pres- ence of hypertension are independent risk factors of NAFLD in male group. The RR for NAFLD significantly increase in patients with MS in male group.