| 非酒精性脂肪性肝病诊疗指南 |
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| 引用本文： | 李慧泉, 陈冰冰, 郑静, 彭荷苇, 潘欣婷, 蔡晓玲, 徐尚华, 彭仙娥. 膳食钠和钾摄入量与非酒精性脂肪肝发病关系病例对照研究[J]. 中国公共卫生, 2021, 37(9): 1371-1375. DOI: 10.11847/zgggws1127361 |
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| 作者姓名： | 李慧泉 陈冰冰 郑静 彭荷苇 潘欣婷 蔡晓玲 徐尚华 彭仙娥 |
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| 作者单位： | 1.福建医科大学公共卫生学院流行病与卫生统计学系，福建 福州 350000;2.福建医科大学附属南平市第一医院 |
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| 基金项目： | 福建省自然科学基金（2019J01316） |
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| 摘 要： | 目的 了解膳食钠和钾摄入量与非酒精性脂肪肝（NAFLD）发病的关系，为NAFLD的综合防治提供流行病学依据。 方法 采用以医院为基础的病例对照研究方法，对2015年4月 — 2017年8月在福建医科大学附属南平市第一医院体检中心经腹部彩超确诊的541例NAFLD新发病例作为病例组及按病例组同性别、年龄（± 5 岁）频数匹配的同期在福建医科大学附属南平市第一医院体检中心进行腹部彩超检查的541名非NAFLD体检者作为对照组进行问卷调查。 结果 病例组NAFLD患者和对照组非NAFLD体检者膳食钠、钾摄入量分别为（818.39 ± 417.60）和（742.27 ± 407.08）mg/d、（1 597.10 ± 686.25）和（1 638.96 ± 660.89）mg/d；2组人群比较，病例组NAFLD患者膳食钾摄入量低于对照组非NAFLD体检者（t = – 3.929，P < 0.001），2组人群膳食钠摄入量差异无统计学意义（P > 0.05）。在调整了性别、年龄、文化程度、职业、家庭人均月收入、吸烟情况、饮酒情况、体育锻炼时间、慢性病病史及膳食能量、蛋白质、胆固醇、脂肪、碳水化合物、钙、铁和钾等混杂因素后，多因素条件logistic回归分析结果显示，膳食钠摄入量第三五分位数和第四五分位数女性人群NAFLD的发病风险分别为最低五分位数女性人群的0.42倍（OR = 0.42，95 % CI = 0.18～0.96）和0.28倍（OR = 0.28，95 % CI = 0.12～0.66）。在调整了性别、年龄、文化程度、职业、家庭人均月收入、吸烟情况、饮酒情况、体育锻炼时间、慢性病病史及膳食能量、蛋白质、胆固醇、脂肪、碳水化合物、钙、铁和钠等混杂因素后，多因素条件logistic回归分析结果显示，膳食钾摄入量第二五分位数、第三五分位数、第四五分位数和最高五分位数人群NAFLD的发病风险分别为最低五分位数人群的0.63倍（OR = 0.63，95 % CI = 0.43～0.94）、0.45倍（OR = 0.45，95 % CI = 0.29～0.69）、0.36倍（OR = 0.36，95 % CI = 0.22～0.58）和0.31倍（OR = 0.31，95 % CI = 0.16～0.58），膳食钾摄入量第三五分位数、第四五分位数和最高五分位数男性人群NAFLD的发病风险分别为最低五分位数男性人群的0.38倍（OR = 0.38，95 % CI = 0.23～0.65）、0.30倍（OR = 0.30，95 % CI = 0.16～0.57）和0.30倍（OR = 0.30，95 % CI = 0.13～0.67）。 结论 全人群和男性人群膳食钾摄入量较高及女性人群膳食钠摄入量较高是NAFLD发病的保护因素。
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| 关 键 词： | 非酒精性脂肪肝（NAFLD） 膳食钠和钾 摄入量 关系 病例对照研究 |
| 收稿时间： | 2019-12-06 |
From NASH to HCC: current concepts and future challenges |
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| LI Hui-quan, CHEN Bing-bing, ZHENG Jing, . Association of dietary sodium and potassium intake with non-alcoholic fatty liver disease: a case-control study[J]. Chinese Journal of Public Health, 2021, 37(9): 1371-1375. DOI: 10.11847/zgggws1127361 |
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| Authors: | LI Hui-quan CHEN Bing-bing ZHENG Jing |
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| Affiliation: | 1.Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province 350000, China |
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| Abstract: | Objective To explore the relationship between dietary sodium (Na) and potassium (K) intake and non-alcoholic fatty liver disease (NAFLD) and to provide references for NAFLD prevention. Methods We conducted a hospital-based case-control study among physical examinees aged 18 – 70 years during a period from April 2015 through August 2017. Using a self-designed questionnaire, we interviewed face-to-face a total of 541 cases (68.21% males and 31.79% females) diagnosed with NAFLD by abdominal ultrasonography at a physical examination center of Nanping City First Hospital and 541 gender- and age frequency-matched controls without NAFLD according to abdominal ultrasonography in the same setting. Results The cases had a significantly lower dietary K intake compared to the controls (1 597.10 ± 686.25 vs. 1 638.96 ± 660.89 mg/d, t = – 3.929; P < 0.001) but the dietary Na intake was not significantly different between the cases and the controls (818.39 ± 417.60 vs.742.27 ± 407.08 mg/d, P > 0.05). The results of multivariate conditional logistic regression analysis demonstrated that (1) for the female participants, those with higher dietary Na intake were at a significantly decreased risk of NAFLD (the Na intake of the third [Q3] to the highest quintile [Q5] vs. the lowest quintile [Q1]: odds ratio [OR] = 0.42, 95% confidence interval [95% CI]: 0.18 – 0.96; the fourth quintile [Q4] to Q5 vs. Q1: OR = 0.28, 95% CI: 0.12 – 0.66) after adjusting for confounding factors such as age, education, occupation, family monthly income per capita, smoking, alcohol drinking, physical exercise time, history of chronic disease, and dietary intakes of energy and protein, cholesterol, fat, carbohydrate, calcium, iron, and potassium; (2) for all the participants, those with higher dietary K intake were at a significantly decreased risk of NAFLD (the K intake of the second quintile [Q2] – Q5 vs. Q1: OR = 0.63, 95% CI: 0.43 – 0.94; Q3 – Q5 vs. Q1: OR = 0.45, 95% CI: 0.29 – 0.69; Q4 – Q5 vs. Q1: OR = 0.36, 95% CI: 0.22 – 0.58; Q5 vs. Q1: OR = 0.31, 95% CI: 0.16 – 0.58) after adjusting all confounding factors mentioned above except for adding gender and substituting potassium with sodium; (3) for the male participants, those with higher dietary K intake were at a significantly decreased risk of NAFLD (the dietary K intake of Q3 – Q5 vs. Q1: OR = 0.38, 95% CI: 0.23 – 0.65; Q4 – Q5 vs. Q1: OR = 0.30, 95% CI: 0.16 – 0.57; Q5 vs. Q1: OR = 0.30, 95% CI: 0.13 – 0.67) after adjusting all confounding factors mentioned above except for gender. Conclusion Higher dietary potassium intake may be a protective factor against NAFLD for both Chinese men and women but higher dietary sodium intake may be a protective factor against NAFLD only for Chinese women. |
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| Keywords: | non-alcoholic fatty liver disease dietary sodium and potassium intake relationship case-control study |
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