中老年干部体检人群代谢综合征及合并心脑血管病的研究

目的探讨中老年干部体检人群代谢综合征(MS)的患病率,各年龄段MS的分布及合并心脑血管病的状况。方法1 985例中老年人进行健康体检。MS患者按年龄分为≤50岁,51~60岁,61~70岁,71~80岁,>81岁5组。分析各年龄组冠心病、高血压、肥胖、血脂异常等患病情况。结果MS患病率26.3%,MS及各组患病情况分析,高血压患病率52.2%,肥胖42.9%,血脂异常34.9%,高血糖34.7%,冠心病20.6%,高尿酸血症14.9%,脂肪肝10.5%,脑卒中5.2%。523例MS患者中,高血压患病率91.8%,肥胖83.7%,血脂异常74.1%,高血糖70.7%。不同年龄组MS患病分析显示,≤60岁组肥胖患病率最高,>61岁各组高血压患病率最高。MS患者60岁以下年龄组脂肪肝患病率最高。>61岁以上各年龄组冠心病患病率最高。MS患者中冠心病、高尿酸血症、脂肪肝和脑卒中等疾病的患病率显著高于非MS受检者。结论MS的高患病率预示心、脑血管疾病患病率的增加。     

老年干部体检人群代谢综合征与心脑血管病的关系

目的探讨老年干部体检人群代谢综合征(MS)的患病率,各年龄段MS的分布及合并心脑血管病的状况。方法1680例老年人进行健康体检,按年龄分为60~69岁,70~79岁,≥80岁3组;同时有500例非老年人(<60岁)进行体验。分析各年龄组冠心病、高血压、肥胖、血脂异常等患病情况。结果老年组MS患病率为29.7%,非老年组为17.0%;老年组高血压患病率为53.4%,肥胖42.8%,血脂异常35.0%,高血糖34.8%。499例老年组MS患者中,高血压患病率91.9%,肥胖83.5%,血脂异常74.0%,高血糖70.8%。MS患者各年龄组冠心病患病率最高。MS患者中冠心病、高尿酸血症、脂肪肝和脑卒中等疾病的患病率显著高于非MS受检者。结论MS的高患病率预示心脑血管病患病率的增加。     

不同年龄男性人群代谢综合征的特点分析

目的探讨不同年龄段男性人群代谢综合征特点,为其防治提供依据。方法回顾性分析北京某机关677例男性干部2007年5月在我院查体资料,按年龄分为4组:33~45岁、46~55岁、56~65岁和65岁,统计各组患病情况及相关异常代谢指标,分析不同年龄组上述指标特点。结果 677例健康体检干部中代谢综合征(MS)总患病率为23.78%,MS主要组成部分患病率从高到低为餐后2 h血糖增高(37.67%)、超重(37.08%)、高三酰甘油血症(31.17%)、高血压(18.02%)、低HDL-C血症(14.18%)、空腹血糖增高(11.37%);各组MS发病率均较高,以46~55岁年龄组最高(31.87%),33~45岁年龄组最低(17.53%),56~65岁年龄组与65岁年龄组患病率相近(P0.05)。各年龄段中,33~45岁年龄组与56~65岁年龄组患病率最高的单项代谢异常疾病为超重(分别为32.47%和38.42%),46~55岁年龄组最高为高三酰甘油血症(46.15%),而65岁年龄组为餐后2 h血糖增高(57.93%)。结论该机关人群MS患病率较高,46~55岁为其高发年龄段,超重及高三酰甘油血症为该人群MS早期主要危险因素,血糖紊乱及高血压为MS晚期主要临床表现,因此应加强干部人群的健康管理,有效预防MS及心脑血管疾病。     

广西钟山县居民高血压前期流行病学调查分析

目的了解广西钟山县居民高血压前期的流行病学情况。方法采用整群抽样方法抽取广西钟山县7个乡镇共15个部门、年龄≥18岁的人群3 000名进行现场流行病学调查分析。结果 3 000被调查者中,正常血压907例(30.24%),高血压病患者541例(18.03%),高血压前期患者1 552例(51.73%)。在1 552例高血压前期患者中,男性733例占54.17%,女性819例占49.73%。随着年龄的增大,人群高血压前期患病率不断增高,不同年龄组男女居民高血压前期患病率比较差异均有统计学意义(P0.05),男性居民高血压前期患病率(54.17%)显著高于女性(49.73%),差异有统计学意义(P0.05)。农村人口高血压前期患病率高于城镇人口(P0.05);农民人群高血压前期患病率显著高于其他各职业人群(P0.05),工人、公务员、教师、医务人员高血压前期患病率比较差异无统计学意义(P0.05)。高血压前期患者高胆固醇血症、高三酰甘油血症、血糖异常、高尿酸血症、超重、肥胖发生率均显著高于正常血压人群,差异有统计学意义(P0.05)。结论广西钟山县居民高血压前期患病率较高,男性、高龄、农民是高血压前期患病的主要人群,高血压前期患者的代谢异常发生率显著高于正常血压人群,必须引起高度重视。     

非酒精性脂肪肝与冠心病危险因素的相关性分析

目的探讨非酒精性脂肪肝（NAFLD）与冠心病危险因素之间的关系。方法从我院2008年5月—2010年3月间门诊就诊和健康体检者中,抽取患及未患非酒精性脂肪肝患者各86例,分析其与年龄、腰围（WI）、体重指数（BMI）、血压、谷丙转氨酶（ALT）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（GLU）、尿酸（UA）之间的关系。结果 NAFLD组有较高的ALT、TG、LDL-C、GLU、UA水平,与非NAFLD组比较,差异有统计学意义（P〈0.01）;NAFLD组合并冠心病和高血压的患病率明显高于非NAFLD组,差异有统计学意义（P〈0.05）。WI、BMI、高血压、高三酰甘油血症、高低密度脂蛋白血症、高血糖与脂肪肝关系密切,OR分别为7.795（P〈0.01）、5.782（P〈0.01）、1.673（P〈0.05）、3.575（P〈0.01）、3.871（P〈0.01）、2.396（P〈0.01）。结论非酒精性脂肪肝与肥胖、高血压、高三酰甘油血症、高低密度脂蛋白血症、高血糖等冠心病的危险因素有相关性。     

脂肪肝或丙氨酸氨基转移酶升高的患者中代谢异常的患病情况比较

目的 比较脂肪肝或丙氨酸氨基转移酶异常的患者中代谢异常的患病情况,探讨两者对代谢的影响.方法 以上海宝钢集团股份公司2001年1月～2002年12月参加体检的职工为研究对象,应用SPSS 11.5软件进行统计处理.结果 在该研究人群中,脂肪肝的患病率为14.08%,其中非酒精性脂肪性肝病（NAFLD）的患病率为11.16%;转氨酶异常的患病率为3.17%,脂肪肝患者中转氨酶异常的患病率为11.7%,转氨酶异常的患者中脂肪肝患病率为51.9%.根据是否患有脂肪肝和转氨酶异常,将研究人群分组后,发现在转氨酶异常的两组间（伴有和不伴有脂肪肝）,性别、年龄、体重指数（BMI）、收缩压、舒张压以及肥胖的患病率无差异,但伴有脂肪肝组的血脂、血糖、血红蛋白的水平以及高血压、高脂血症和空腹血糖异常（IFG）及糖尿病的患病率明显高于无脂肪肝组（P＜0.01）;而在患有脂肪肝两组间（伴有和不伴有转氨酶异常）,转氨酶异常组的年龄、BMI、血压和血红蛋白的水平以及肥胖和高血压的患病率高于转氨酶正常组（P＜0.01）,而血脂、血糖的水平及高脂血症、IFG、糖尿病的患病率两组间无差异.结论 单纯脂肪肝对血脂、血糖的影响要大于其对BMI、血压的影响.脂肪肝患者出现转氨酶异常,可能不仅仅是肝脏损伤的表现,还可能是年龄增长、肥胖和高血压加重的表现.     

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。     

1995至2002年上海宝钢职工队列人群脂肪肝患病率变化

目的探讨近10年上海宝钢职工脂肪肝患病率的动态变化.方法回顾性分析1995-2002年间宝钢职工隔年健康体检资料,根据B超检查结果诊断脂肪肝,规定血清丙氨酸转氨酶(ALT)大于40 U/L为转氨酶升高.结果研究期间59 131人次参加体检,其中参加4次者27.1%,3次者26.6%,2次者24.0%.肥胖和代谢紊乱患病率在基线水平时已较高,随时间进展更加明显.随访中无论是男性还是女性,脂肪肝患病率均不断增高,总体脂肪肝患病率从1995-1996年的3.87%上升至2001-2002年的14.04%,血清ALT升高者脂肪肝检出率从25.88%上升至51.39%.各个时点总体脂肪肝患病率均以50～60岁组最高,同一时点男性脂肪肝患病率高于女性.结论上海宝钢职工脂肪肝患病率增长迅速,并已成为血清转氨酶异常的主要原因,肥胖和代谢紊乱可能与其高发有关.     

泸州市社区老年人群超重、肥胖患病率及特点分析

目的:了解泸州市社区老年人群超重和肥胖的流行特点及其高血压、高血糖、高血脂的患病情况。方法:通过多级抽样方法,对泸州市社区60岁以上居民进行问卷调查、体格检查、生化检测。体质量指数(BMI)≥28.0为肥胖,24.0～27.9为超重。结果:共收集有效资料4 445份,平均BMI为24.1±3.4,男性与女性BMI不同(P<0.001)。样本人群超重和肥胖患病率分别为38.25%、12.78%;各年龄段超重率不同(P<0.05),60～69年龄段超重率最高(P<0.05),随年龄的增长,超重率有下降趋势(P<0.001);男、女性肥胖率分别为10.01%、14.69%(P<0.001),各年龄组肥胖率差异无统计学意义。高血压、高血糖、高三酰甘油等患病率随BMI升高而增加(P<0.05),在超重、肥胖组的患病率高于BMI<24.0组(P<0.05)。结论:被调查人群超重和肥胖患病率超过50%,其高血压、高血糖、高血脂患病率达40%以上;老年人超重、肥胖问题严峻,控制老年超重和肥胖刻不容缓。     

上海市奉城社区30岁以上人群代谢综合征及其相关疾病的流行病学调查

目的：调查上海市奉城社区代谢综合征（MS）及其相关疾病的患病情况。方法：随机整群抽取奉城镇灯民村及洪南村30岁以上村民1041人列入本次分析。MS的诊断以国际糖尿病联盟（IDF）2005年4月制定的工作定义及诊断标准为依据。结果：①上海奉城社区30岁以上人群中常见代谢病患病率较高,超重、肥胖、中心性肥胖、糖调节异常（IGR）、糖尿病（DM）、高血压、高三酰甘油（TG）血症以及MS患病率分别为38.14%、11.24%、49.09%、15.05%、4.71%、58.69%、17.77%、26.51%;②上述疾病发病率随年龄增长而增加,其中50岁以上人群超重、中心性肥胖、IGR、DM、高血压、高TG血症及MS发病率是50岁以下人群的1.07～3.55倍;③高血压前期发病率为14.41%,随年龄增长高血压患病率的增多呈下降趋势;④社区中2/3以上人群患有不同程度代谢异常,1/3以上人群患有2种以上代谢异常。结论：上海农村社区人群具有较高的MS及相关疾病患病率。     

Fatty liver and the metabolic syndrome among Shanghai adults

BACKGROUND AND AIM: To explore the relationship between fatty liver and the metabolic syndrome in the adults of Shanghai and evaluate the value of fatty liver as a marker for risk factor clustering. METHODS: Questionnaires, physical examinations, laboratory tests (blood lipid and glucose) and real-time liver ultrasonographies were performed in Shanghai adults and analyzed using randomized, multistage, stratified cluster sampling. Prevalence of the metabolic syndrome was defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria with the exception of abdominal obesity (waist circumference > 90 cm in men and > 80 cm in women); fatty liver was diagnosed in accordance with the presence of an ultrasonographic pattern consistent with 'bright' liver (brightness and posterior attenuation of liver). RESULTS: The study population consisted of 3175 subjects (1218 men) with a mean (+/- SD) age of 52.4 +/- 15.1 years. Metabolic syndrome and fatty liver were found in 726 (22.87%) and 661 (20.82%) of sampled cases, respectively. After adjustment by age and sex, the prevalence of the metabolic syndrome and fatty liver in the general population of Shanghai were 15.30 and 17.29%, respectively. The risk for fatty liver in subjects with abdominal obesity, diabetes, dyslipidemia and hypertension increased 32.78-fold (95% confidence interval (CI) 14.85-72.35), 31.58-fold (95% CI 14.18-70.35), 22.64-fold (95% CI 10.26-49.99) and 23.25-fold (95% CI 10.54-51.30), respectively, compared with controls, whereas the risk for fatty liver in subjects with metabolic syndrome was increased by 39.33-fold (95% CI 17.77-87.05). After the 661 patients with fatty liver had been stratified by body mass index (BMI), the prevalence of abdominal obesity, hypertension and the metabolic syndrome were increased from 25.0, 47.2 and 36.1%, respectively, in people with normal BMI to 81.0, 73.8 and 55.4%, respectively, in obese persons. However, the prevalence of hypertriglyceridemia, high fasting glucose and low high-density lipoprotein-cholesterol showed no significant changes with increased BMI. Moreover, among fatty liver patients with normal BMI, the detection rate for one or more features of metabolic disorders was as high as 83.3% and that for five features was 2.8%. Compared with obesity (BMI > or = 25 kg/m2) and abdominal obesity, fatty liver had the highest clustering rate, specificity, positive predictive value and attributable risk percentage in detecting risk factor clustering in both sexes. CONCLUSIONS: There is a high prevalence of metabolic syndrome and fatty liver among Shanghai adults. Metabolic disorders are closely related to fatty liver; moreover, fatty liver appears to be a good predictor for the clustering of risk factors for metabolic syndrome.     

The importance of metabolic factors for the increasing prevalence of fatty liver in Shanghai factory workers

BACKGROUND AND AIM: To evaluate changes in the prevalence rates of ultrasonographic fatty liver (FL) in a specific population. METHODS: An analysis of the medical records of BaoSteel Group (Shanghai, China) employees was done to evaluate the prevalence of FL in this population, in which health examinations were performed biennially between 1995 and 2002. RESULTS: The study reviewed a database of 59 131 employees, of which 27.1% received medical check-ups four times within the study period, 26.6% three times, and 24.0% twice. The prevalence rates of obesity and metabolic disorders were high at baseline and increased significantly with time. The prevalence of ultrasonographic FL increased from 3.87% to 14.04% in the overall population, while there was an increase from 4.44% to 14.64% in men and 1.56% to 11.37% in women over the 6-year study period. Increased rates of FL were also noted, from 25.88% to 51.39%, among patients with elevated serum alanine aminotransferase (ALT) levels (> 40 U/L). The highest overall prevalence rates of FL were found in individuals aged 50-60 years, with all age-associated prevalence significantly higher in males than females. CONCLUSION: The prevalence of FL increased rapidly over the study period with increased rates of obesity and metabolic disorders; FL is becoming a major cause of abnormal ALT levels in the specific population.     

What are the risk factors and settings for non‐alcoholic fatty liver disease in Asia–Pacific?

The risk factors and settings for non-alcoholic fatty liver disease (NAFLD) in Asians are reviewed comprehensively. Based particularly on large community-based studies using ultrasonography, case-control series and prospective longitudinal studies, the prevalence of NAFLD in Asia is between 12% and 24%, depending on age, gender, locality and ethnicity. Further, the prevalence in China and Japan has nearly doubled in the last 10-15 years. A detailed analysis of these data shows that NAFLD risk factors for Asians resemble those in the West for age at presentation, prevalence of type 2 diabetes mellitus (T2DM) and hyperlipidemia. The apparent differences in prevalence of central obesity and overall obesity are related to criteria used to define waist circumference and body mass index (BMI), respectively. The strongest associations are with components of the metabolic syndrome, particularly the combined presence of central obesity and obesity. Non-alcoholic fatty liver disease appears to be associated with long-standing insulin resistance and likely represents the hepatic manifestation of metabolic syndrome. Not surprisingly therefore, Asians with NAFLD are at high risk of developing diabetes and cardiovascular disease. Conversely, metabolic syndrome may precede the diagnosis of NAFLD. The increasing prevalence of obesity, coupled with T2DM, dyslipidemia, hypertension and ultimately metabolic syndrome puts more than half the world's population at risk of developing NAFLD/non-alcoholic steatohepatitis/cirrhosis in the coming decades. Public health initiatives are clearly imperative to halt or reverse the global 'diabesity' pandemic, the underlying basis of NAFLD and metabolic syndrome. In addition, a perspective of NAFLD beyond its hepatic consequences is now warranted; this needs to be considered in relation to management guidelines for affected individuals.     

Effects of nonalcoholic fatty liver disease on the development of metabolic disorders

Background and Aim: Nonalcoholic fatty liver disease (NAFLD) is considered to be the liver component of metabolic syndrome. However, the impact of NAFLD on metabolic syndrome is unclear. The aim of this study was to explore the influence of NAFLD on the development of metabolic disorders. Methods: Patients with NAFLD and an age, sex, and occupation‐matched control group were recruited from employees of Bao‐Steel Group (Shanghai, China) who had received medical check‐ups biennially between 1995 and 2002. Anthropometric and laboratory data, and incidence of metabolic disorders were assessed at baseline and at follow‐up of at least 4 years. SPSS 11.5 was used for statistical analysis. Results: The study consisted of 358 patients (326 men and 32 women) and 788 matched controls (711 men and 77 women) with a similar mean age of 39.0 years and median follow‐up of 6 years. At the end of follow‐up, incidence of obesity (47.6% vs 19.5%), hypertension (69.6% vs 16.3%), hypertriglyceridemia (39.1% vs 16.3%), hypercholesterolemia (24.5% vs 17.3%), impaired fasting glucose (IFG) (25.1% vs 11.6%), diabetes mellitus (20.3% vs 5.2%) and multiple metabolic disorders (MMD) (56.3% vs 16.3%) were significantly higher in the fatty liver group than the control group. Interestingly, the mean alanine aminotransferase (ALT) level in patients with fatty liver significantly decreased at follow‐up compared with baseline (28.56 ± 18.86 vs 31.51 ± 18.34 U/L, P < 0.05). To separate the effects of obesity from fatty liver, the subjects were re‐classified according to the presence of obesity and fatty liver at baseline. The incidence of hypertension (61.1% vs 41.3%), hypertriglyceridemia (38.1% vs 15.0%), hypercholesterolemia (29.9% vs 16.6%), IFG (21.3% vs 10.0%) and diabetes (11.1% vs 4.3%) were significantly higher in the fatty liver group without obesity (n = 84) than in the group with without fatty liver or obesity (n = 614). In addition, the incidence of hypertension (72.9% vs 57.4%), hypertriglyceridemia (39.4% vs 22.7%) and diabetes (23.2% vs 8.4%) was higher in the group with fatty liver and obesity (n = 274) than in the group with obesity alone (n = 174). Conclusions: The presence of NAFLD might predict the development of metabolic disorders due to insulin resistance, rather than obesity itself. ALT levels decreased over time in patients with fatty liver.     

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、     

Nonalcoholic fatty liver,steatohepatitis, and the metabolic syndrome

Nonalcoholic fatty liver disease (NAFLD) has been associated with the insulin-resistance syndrome, at present defined as the metabolic syndrome, whose limits were recently set. We assessed the prevalence of the metabolic syndrome in 304 consecutive NAFLD patients without overt diabetes, on the basis of 3 or more criteria out of 5 defined by the U.S. National Institutes of Health (waist circumference, glucose, high-density lipoprotein [HDL]-cholesterol, triglycerides, and arterial pressure). The prevalence of the metabolic syndrome increased with increasing body mass index, from 18% in normal-weight subjects to 67% in obesity. Insulin resistance (Homeostasis Model Assessment method) was significantly associated with the metabolic syndrome (odds ratio [OR], 2.5; 95% CI, 1.5-4.2; P <.001). Liver biopsy was available in 163 cases (54%). A total of 120 patients (73.6%) were classified as having nonalcoholic steatohepatitis (NASH); 88% of them had a metabolic syndrome (vs. 53% of patients with pure fatty liver; P <.0001). Logistic regression analysis confirmed that the presence of metabolic syndrome carried a high risk of NASH among NAFLD subjects (OR, 3.2; 95% CI, 1.2-8.9; P =.026) after correction for sex, age, and body mass. In particular, the syndrome was associated with a high risk of severe fibrosis (OR, 3.5; 95% CI, 1.1-11.2; P =.032). In conclusion, the presence of multiple metabolic disorders is associated with a potentially progressive, severe liver disease. The increasing prevalence of obesity, coupled with diabetes, dyslipidemia, hypertension, and ultimately the metabolic syndrome puts a very large population at risk of forthcoming liver failure in the next decades.     

人体质量指数及其变化与非酒精性脂肪性肝病发病的关系

目的 探讨健康成人基线体质量及其变化与非酒精性脂肪性肝病(NAFLD)发病的关系.方法 回顾性分析1999年和2001年上海宝山钢铁责任有限公司的普通员工健康体检资料,主要包括个人嗜好、既往病史、人体学指标、动脉血压,空腹血清甘油三酯(TG)、总胆固醇、葡萄糖、ALT以及肝脏实时超声的检查结果.选择研究期间无习惯性饮酒史[每月饮酒小于2次和(或)每周饮用乙醇量小于140 g]以及基线时血清ALT正常(小于40 U/L)和实时超声检查未发现脂肪肝者为研究对象.血清生物化学指标用Bayer 1650全自动生物化学分析仪测定,由同一名资深影像学医师利用同一台1400型Aloka实时超声显像仪(探头频率3.5MHz)作肝脏检查.应用SPSS12.0统计软件进行数据分析,计量资料用均数±标准差表示,采用t检验、方差分析、非参数检验.计数资料用率表示,采用x2检验.结果 有5402例研究对象2年后再次体检时影像学诊断脂肪肝327例(6.05%),每1000人每年发生NAFLD 30例.年龄＜50岁发生脂肪肝者占5.7%(281/4624),≥50岁发生脂肪肝者占9.3%(46/451),x2=9.87,P＜0.01.人体质量指数(BMI)差值在无脂肪肝组为0.50±1.29,脂肪肝组为0.95±1.25,t-6.11,P＜0.01.TG差值在无脂肪肝组为(0.11±1.06)mmol/L,脂肪肝组为(0.35±1.71)mmol/L,t=2.48,P＜0.05.TC差值无脂肪肝组为(0.52±0.63)mmol/L,脂肪肝组为(0.62±0.70)mmol/L,t=2.40,P＜0.05.NAFLD的发病率随基线BMI增加而显著增高,趋势分析显示x2=389.01,P=0.000.体质量正常、超重、肥胖症和重度肥胖症患者NAFLD发病率分别为1.4%、6.4%、16.8%和24.5%.多元回归分析显示基线年龄、BMI和血清TG水平以及随访期间BMI和TG增加幅度与NAFLD的发病密切相关.结论 普通职工NAFLD发病率高,基线时肥胖和代谢紊乱以及随访中体质量和TG增加是发生NAFLD的重要预测因素.     

云南省布朗族成人非酒精性脂肪性肝病流行特点研究

目的 调查云南省勐海县布朗族成人非酒精性脂肪性肝病(NAFLD)的流行特点及其它代谢性疾病的患病情况.方法 2017年2～3月对布朗族聚集且交通便利的5个行政村、18岁及以上3365名居民进行普查,纳入研究3258名.采用问卷调查、体格检查、实验室检测和超声检查.以2010年第六次全国人口普查的人口构成为标准人口构成,...     

Roles of gender, obesity, and lifestyle-related diseases in alcoholic liver disease: Obesity does not influence the severity of alcoholic liver disease

Aim: To elucidate gender differences and the influence of obesity and/or metabolic syndrome‐related fatty liver on alcoholic liver disease (ALD), we analyzed characteristic features of ALD. Methods: We investigated 266 ALD patients (224 males and 42 females) without hepatocellular carcinoma stratified by gender and the presence of cirrhosis. Male and female patients matched for age and total ethanol intake were also analyzed. A diagnosis of ALD was based on alcohol intake (>70 g daily for more than 5 years), clinical features, and exclusion of other liver diseases. The prevalence of obesity, lifestyle‐related diseases, and psychological disorders were assessed. Results: The prevalence of psychological disorders showed a significant gender difference among all ALD patients (12% in males versus 43% in females, P < 0.001), as well as in patients matched for age and total ethanol intake. There were 156 cirrhotic patients. Absence of dyslipidemia, presence of diabetes, and high total ethanol intake were selected as independent predictors of cirrhosis in males by multivariate analysis after excluding laboratory data of liver function tests. The prevalence of obesity was significantly lower in cirrhotic male patients than in non‐cirrhotic male patients (34% vs. 20%, P = 0.023). Among females, there were no significant predictors of cirrhosis on multivariate analysis after eliminating liver function tests. The prevalence of obesity and diabetes was similar in non‐cirrhotic and cirrhotic female patients. The prevalence of psychological disorders was 47% in cirrhotic females with ALD. Conclusions: Obesity was not common in cirrhotic ALD. Psychological disorders seem to be important for female ALD.