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1.
目的了解乌鲁木齐地区机关汉族成人非酒精性脂肪肝及酒精性脂肪肝的流行状况,并分析非酒精性脂肪肝与代谢综合征的关系。方法对1037例体检者的问卷调查、体格检查、生化、肝脏超声检查等相关资料进行分析。结果乌鲁木齐地区成人脂肪肝检出278例,脂肪肝发生率为检出率为26.8%,非酒精性脂肪肝188例,占18.1%,其中男性161例,女性27例;酒精性脂肪肝90例,占8.7%,其中男性84例,女性6例,男性NAFLD高于女性。NAFLD患者合并MS共计115例,伴有率为61.2%。结论乌鲁木齐地区机关汉族成人脂肪肝(NAFLD及AFLD)患病率远高于国内以及世界范围平均患病率,体现了低龄化趋势及中年年龄段的患病高峰特点;年龄、BMI、WHR、TG以及FPG为NAFLD的相关危险因素,NAFLD可以作为MS组成成分之一。  相似文献   

2.
Background and Aim: Non‐alcoholic fatty liver disease (NAFLD) is becoming a major public health hazard in China. The present study aimed to estimate the prevalence of NAFLD, NAFLD with abnormal serum alanine aminotransferase (ALT) levels, and determine the potential associations of ALT levels with the components of metabolic syndrome (MetS) in the absence or presence of NAFLD in Chinese adults. Methods: A population‐based cross‐sectional survey was conducted with 2226 participants. Physical examinations, laboratory tests and hepatic ultrasounds were performed. Individuals were further stratified into higher or lower ALT subgroups with the upper quartiles of ALT in this population. The MetS was identified according to the criteria of the Chinese Joint Committee for Developing Chinese Guidelines (JCDCG). Results: The standardized prevalence of NAFLD was 23.3% (NAFLD with abnormal ALT levels, 3.1%), 26.5% (NAFLD with abnormal ALT levels, 5.1%) in males, and 19.7% (NAFLD with abnormal ALT levels, 0.9%) in females. Multivariate logistic analysis revealed that higher ALT was significantly associated with elevated triglyceride (TG) in the non‐NAFLD participants, independent of age, smoking status, drinking status, and other MetS‐related measures with odds ratios (95% confidence intervals) of 3.4 (1.6–7.1) and 2.3 (1.4–3.7) in males and females, respectively. On the other hand, the higher ALT was statistically associated with elevated TG and hyperglycemia in the NAFLD cases with odds ratios of 2.2 to 2.5 (P < 0.05). Conclusions: The prevalence of NAFLD has become epidemic in Shanghai adults. NAFLD combined with ALT levels may be used to identify the individuals at the different risk levels of metabolic disorders.  相似文献   

3.

Objective

The aim of this study was to investigate the metabolic risk factors for fatty liver disease in the elderly, and determine the prevalence of fatty liver disease in the elderly in Wuhan, central China.

Methods

The study was a case–control study based on all 4226 adults above 60 years of age from a cohort investigated in 2010–11 at the medical examination center of Zhongnan hospital, using 3145 randomly selected adults under 60 years of age from the same cohort as controls. Fatty liver disease (FLD) was identified with ultrasound imaging. The risk factors measured were body mass index (BMI), and plasma concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low density lipoprotein (LDL) and serum uric acid (SUA). The probability of steatohepatitis with advanced fibrosis was predicted using a score based on BMI, age, ALT, and TG (BAAT),and using AST/ALT ratio (AAR).

Results

FLD was higher in the elderly (26.7%) than in the non-elderly (22.8%) and similar in the elderly between men and women (26.6% vs 27.0%, p > 0.05). BMI, TC, TG, LDL, SUA, AST and ALT were all significantly higher in FLD, whereas the level of HDL was markedly lower. Multiple regression analyses showed that obesity, high TC, TG, SUA, low HDL, and elevated ALT, AAR < 1 were closely related to the elderly FLD, while male sex, obesity, high TC, TG, low HDL, elevated ALT, AST and AAR < 1 were closely related to the non-elderly FLD. The prevalence of steatohepatitis with advanced fibrosis estimated as BAAT index ≥ 3 was 2.4% in all subjects, and was higher in the elderly FLD patients than in the non-elderly FLD patients.

Conclusion

The prevalence of FLD is higher in the elderly, and is broadly related to the same metabolic risk factors as in the non-elderly. However, female-sex is no longer protective with increasing age, and the prevalence of steatohepatitis with advanced fibrosis is estimated to be considerably higher in the elderly FLD patients than in the non-elderly FLD controls.  相似文献   

4.
BACKGROUND AND AIM: It is known that ultrasonography (US) cannot differentiate between non-alcoholic fatty liver disease (NAFLD) and steatohepatitis. However, US can accurately estimate the severity of the steatosis. The clinical significance of severe hepatic fatty change by US has not been explored. The aim of this study was to investigate the relationship between the severity of the fatty liver, classified by US, and the degree of metabolic disorders with insulin resistance. METHODS: In 16 486 Taiwanese patients, severity of fatty change on US was classified as follows: group A (n = 6950), absence of fatty change; group B (n = 8694), mild; and group C (n = 842), severe fatty liver change. Biometabolic parameters included body mass index (BMI), blood pressure (BP), fasting plasma glucose, triglycerides, cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and serum creatinine. Nominal logistic regression analysis was used to estimate the odds ratio for different degrees of fatty liver. RESULTS: The frequencies of obesity, hypertension, glucose intolerance and hypertriglyceridemia were all significantly higher in group C than in group A or B (P < 0.0001), and the mean values of BMI, BP, fasting glucose, triglyceride and ALT were also higher in group C (P < 0.0001). High BMI (>or=30 kg/m(2)) appears to be the most important factor for progression from mild to severe fatty liver in both sexes. CONCLUSIONS: The presence of severe fatty liver by US correlated significantly with the prevalence and degree of hypertension, abnormal glucose and triglyceride metabolism. Patients with severe fatty liver could be at an increased risk of atherosclerotic cardiovascular disease and should be screened regularly for metabolic disorders. The physician may also evaluate ALT and hepatic fat content by US in patients with metabolic syndrome. Evaluating the severity of fatty liver by US may be useful because it correlates with the status of hyperinsulinemia, the risks of developing cardiovascular disease, and the threshold for oxidative stress.  相似文献   

5.
Background and Aim: Differences in the prevalence of non‐alcoholic fatty liver disease (NAFLD) between Eastern and Western populations are primarily attributable to differences in definitions and biased population selection. Thus, the aim of the present study was to accurately determine the actual prevalence of NAFLD by sonography and to characterize the risk factors for NAFLD. Methods: The present cross‐sectional study was performed with data obtained from 6648 subjects, all of whom were older than 20 years of age (3530 men and 3118 women). The term ‘non‐drinker’ was applied to men who consumed less than 30 g alcohol/day and to women who consumed less than 20 g alcohol/day. Non‐alcoholic fatty liver disease was defined as a sonographically detected fatty liver in the absence of viral hepatitis in a non‐drinker. Results: Of the 1613 subjects who were diagnosed with sonographic fatty liver, 1240 were non‐drinkers and had no viral hepatitis. Overall, the unadjusted and age‐adjusted prevalences of NAFLD were 18.7% (23% in men, 13.7% in women) and 16.1% (21.6% in men, 11.2% in women), respectively. Multivariate analysis revealed that several risk factors were profoundly associated with the prevalence of NAFLD, including obesity, insulin resistance, hyperlipidemia and hyperglycemia in both genders, as well as age, menopausal status and estrogen medication in women only. Conclusions: These results demonstrate that the prevalence of NAFLD in Korean adults, according to sonographic surveys, is comparable to that seen in more developed countries. From the perspective of increasing obesity, the high prevalence rates noted in the study may herald an increased burden of chronic liver disease in the Korean population.  相似文献   

6.
BACKGROUND:Fatty liver disease(FLD)is increasingly recognized as one of the most common chronic liver diseases in China.This study aimed to investigate the prevalence and risk factors of FLD in Chengdu,Southwest China,and to provide a relevant basis for the prevention and intervention of FLD. METHODS:Altogether 9094 subjects(4721 men and 4373 women)of over 18 years old who had received a medical checkup in the West China Hospital of Sichuan University between January and December 2007 were evaluated for FLD...  相似文献   

7.
目的明确邵阳市区成年居民脂肪肝患病率及其主要的危险因素。方法通过多阶段分层随机抽样,对邵阳市3个城区26个社区18岁以上居民进行调查,调查的内容涉及问卷调查、体格检查、生化检测及肝胆B超检查。结果5267例成人完成调查,占邵阳市区总人口的1.24%,脂肪肝患病率为24.2%,男性明显高于女性,脂肪肝组收缩压、舒张压、BMI、空腹血糖、TG、TCH、LDL—C、超重肥胖、高帆精、血脂异常和高血压患病率均明显高于非脂肪肝组(P〈0.05),多因素分析结果显示,体重指数、甘油三酯、胆周醇、文化程度和舒张压等5项指标与脂肪肝密切相关。结论邵阳市区成年居民脂肪肝患病率高。超重肥胖及其相关的多元代谢紊乱与脂肪肝关系密切。  相似文献   

8.
Insulin resistance is the basis of both non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS), the two conditions are often found in the same individual. The mortality of patients with NAFLD is significantly higher than that among the general population and cardiovascular risk may compete with liver-related risk in dictating the final outcome. Recent prospective studies have reported that NAFLD is associated with an increased incidence of MetS and type 2 diabetes mellitus, independent of obesity and other components of MetS. Thus, NAFLD may not only be a liver disease but also an early mediator of type 2 diabetes mellitus and MetS. The biological mechanisms by which NAFLD contributes to a higher risk of developing metabolic disorders are not fully understood. However, the fatty liver could contribute in the same way as visceral adipose tissue to insulin resistance, systemic inflammation and oxidative stress, while the decreased serum adiponectin concentrations might also be part of the mechanism. In contemporary clinical practice, it has become mandatory to evaluate the metabolic risk factors in NAFLD patients and to consider careful surveillance and aggressive treatment, not only of the resultant liver disease, but also of the possible underlying metabolic and vascular complications. Future studies might address the question whether earlier adjustment to a more efficient lifestyle or a pharmacological treatment that mobilizes fat out of the liver could reduce these risks.  相似文献   

9.
儿童和青少年时期非酒精性脂肪性肝病(NAFLD)是以肝细胞脂肪变性和脂肪蓄积为病理特征,而无饮酒史的临床综合征,它是代谢综合征和胰岛素抵抗在肝脏的表现,与儿童期的肥胖、性别、胰岛素抵抗和青春期具有相关性。因此,本病在儿童和青少年时期的诊断和评估要充分考虑不同于成人的许多高发风险因素,如性别、青春期的发育等因素。  相似文献   

10.
非酒精性脂肪性肝病的发病与胰岛素抵抗及其表型有关。胰岛素抵抗和代偿性高胰岛素血症是代谢综合征的中心环节。非酒精性脂肪性肝病是代谢综合征的临床疾病谱之一。非酒精性脂肪性肝病与动脉粥样硬化性心血管疾病、2型糖尿病及代谢综合征临床症候群的关系密切,本文就非酒精性脂肪肝与代谢综合征的关系作一综述。  相似文献   

11.
Fatty liver (hepatic steatosis) is prevalent in industrialized countries. It is typically linked to obesity, central obesity and the presence of metabolic syndrome. With the introduction of a Westernized lifestyle and the increasing frequency of obesity in the Asia‐Pacific region, the prevalence of non‐alcoholic fatty liver disease (NAFLD) has been increasing over the past two decades. The risk factors are similar to those in other ethnic populations; but it is important to adopt the regional (ethnic‐specific) anthropometric criteria to define overweight, obesity (including central obesity) and metabolic syndrome. To be noted, even using strict ethnic‐specific criteria, a high percentage (15–21%) of Asia‐Pacific NAFLD subjects in some series have been found to be non‐obese, i.e. to have a normal body mass index (BMI) (17.5–22.4 kg/m2) or to be overweight (BMI 22.5–24.9 kg/m2). Differential distribution of visceral adipose tissue, recent increase in body weight, intake of high cholesterol diet and genetic background are factors likely associated with the development of NAFLD in these non‐obese (but often overweight) Asia‐Pacific subjects. Furthermore, insulin resistance may be the underlying key mechanism. In addition, since NAFLD may be the hepatic manifestation of metabolic syndrome, the presence of NAFLD is a predictor of future type 2 diabetes, metabolic syndrome and cardiovascular disease. Therefore, interventions at the public health level are indicated to halt the trend of overweight as well as obesity in Asia‐Pacific region, particularly among those with relevant family history. Since the pathophysiology of NAFLD is closely related to metabolic derangement, lifestyle modification remains the cornerstone of management.  相似文献   

12.
13.
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.  相似文献   

14.
目的探讨上海宝钢职工非酒精性脂肪性肝病(NAFLD)的消退率及其影响因素。方法回顾性分析1999年和2001年上海宝钢职工健康体检资料,选择无过量饮酒、基线时丙氨酸转氨酶正常以及乙肝表面抗原阴性者作为研究对象。结果基线时440例NAFLD患者2年后影像学脂肪肝消退60例(13.6%,脂肪肝消退组),380例脂肪肝持续存在(脂肪肝未消退组),另有4867例两次体检都无脂肪肝的个体作为对照(无脂肪肝组)。女性年龄<50岁者脂肪肝消退率显著高于≥50岁者[33.3%(3/9)对4.3%(1/46),χ2=4.969,P<0.01]。脂肪肝的消退率随着基线时体重指数(BMI)的增高而下降,体重正常、超重、肥胖和重度肥胖患者NAFLD消退率分别为18.2%、16.5%、13.5%、7.8%。随访期间,BMI差值在脂肪肝消退组(-0.26±1.18)、脂肪肝未消退组(0.39±1.13)、无脂肪肝组(0.50±1.29)之间差异有统计学意义(F=11.41,P<0.01);血清甘油三酯(TG)差值在脂肪肝消退组[(-0.27±0.79)mmol/L]、脂肪肝未消退组[(0.24±1.88)mmol/L]、无脂肪肝组[(0.11±1.07)mmol/L]之间差异亦有统计学意义(F=5.58,P<0.01)。多元回归分析显示,基线BMI和血清TG水平以及随访期间BMI、TG变化幅度与NAFLD的消退密切相关。结论 NAFLD的消退率相对较低,基线BMI和血清TG水平及其动态变化是影响NAFLD消退的独立因素。  相似文献   

15.
Background and Aim:  Patients with non-alcoholic fatty liver disease (NAFLD) have an increased risk of atherosclerosis and alanine aminotransferase (ALT) is associated with insulin resistance independently of metabolic factors. The aim of the present study was to investigate whether NAFLD patients with ALT elevation had a higher risk of carotid atherosclerosis.
Methods:  A total of 190 individuals were enrolled from the health management center. Among them, 20 subjects were excluded due to the presence of hepatitis B surface antigen (HbsAg), anti-hepatitis C virus (HCV) and cardiovascular disease. NAFLD was diagnosed by ultrasound examination. Carotid ultrasonography was used to measure maximal intima-media thickness (IMT) of the common carotid artery (CCA) and IMT (mean) > 1.0 mm was defined as the presence of carotid atherosclerosis.
Results:  NAFLD patients with ALT elevation had increased risk of carotid atherosclerosis than those with normal ALT by Fisher's exact test ( P  < 0.05). Multivariate analyses showed that serum ALT levels were positively associated with carotid atherosclerosis after adjustment for age, sex, number of metabolic syndrome components or status of metabolic syndrome (OR, 1.44; 95% CI 1.09–1.89; OR, 1.45; 95% CI 1.11–1.91). In addition, the higher the serum ALT levels with every 10 IU/L increment, the greater the risk of carotid atherosclerosis.
Conclusions:  Serum ALT levels are positively associated with the risk of carotid atherosclerosis in patients with NAFLD, suggesting that serum ALT levels could serve as a surrogate marker of cardiovascular risk in this special clinical setting.  相似文献   

16.
探讨奥利司他(orlistat)在治疗肥胖伴非酒精性脂肪性肝病(NAFLD)中的作用。选择体重指数(BM I)在25和32之间,伴有肝功能异常的NAFLD患者30例,给予奥利司他120mg,日三次口服,治疗24周。治疗结束后,所有患者的体重、BM I、腰围、腰臀比及血压明显下降(P值均<0.001);肝功能中ALT、AST、GGT、Tch、TG及IR与治疗前相比有明显改善(P值均<0.001);肝脏CT密度值及肝/脾CT密度比值均显著增加(P值均<0.001)。奥利司他可有效地减少NAFLD患者肝脏内脂肪沉积,改善肝功能和相关代谢综合征,可作为肥胖伴NAFLD的药物治疗选择。  相似文献   

17.
目的:探讨2型糖尿病(T2DM)患者合并非酒精性脂肪肝(NAFLD)及脂肪肝纤维化的危险因素。方法采集2008年5月至2009年12月期间,上海交通大学附属第六人民医院内分泌科住院的1109例T2DM患者的病史资料、生化指标、肝脏超声检查结果,根据B超检查结果将患者分为T2DM组和T2DM合并NAFLD组,采用非酒精性脂肪肝纤维化评分(NAFLDFS)的高诊断阈值(>0.676)、低诊断阈值(<-1.455)将T2DM合并NAFLD组分为纤维化亚组、不确定亚组、无纤维化亚组进行分析。结果(1)T2DM合并NAFLD患者体质量指数(BMI)、腰围(WC)、臀围(HC)、腰臀比(WHR)、舒张压(DBP)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、总胆红素(TBIL)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、空腹血糖(FPG)、餐后2h血糖(2hPBG)、空腹C肽(FCP)、FCP代替胰岛素改良稳态模型指数(HOMA-C肽)均更高(P<0.01或P<0.05),而年龄、糖尿病病程、高密度脂蛋白胆固醇(HDL-C)则显著低于T2DM患者(P<0.01,表1)。(2)逐步logistic回归提示BMI[比值比(OR)=1.325,95%CI 1.249~1.406]、ALT(OR=1.025,95%CI 1.013~1.038)、TG(OR=1.283,95%CI 1.105~1.490)是T2DM合并NAFLD的危险因素,HDL(OR=0.532,95%CI 0.286~0.989)则是保护因素。(3) T2DM合并NAFLD患者中,纤维化亚组占13.4%。与无纤维化及不确定两亚组比较,年龄、病程、BMI、WC、HC、收缩压(SBP)、AST/ALT、GGT、糖化血红蛋白(HbA1c)显著增加(P<0.01),然而ALT、白蛋白(ALB)、TG、血小板(Plt)显著减少(P<0.01或P<0.05),差异具有统计学意义。(4)有序多因素logistic回归提示,年龄、BMI、ALB、AST/ALT、Plt是T2DM合并NAFLD肝纤维化的危险因素。结论住院T2DM合并NAFLD患者比例较大,与BMI  相似文献   

18.
19.
Nonalcoholic fatty liver disease(NAFLD) is a global public health concern owing to its substantial contribution to chronic liver diseases. The disease is closely linked to metabolic syndrome(MS), suggesting a common biological pathway and shared disease mechanism for both ailments. Previous studies revealed a close relationship of NAFLD with the components of MS including abdominal obesity,dyslipidemia, hypertension, and hyperglycemia. Hence, a group of experts recently renamed NAFLD as metabolic dysfunction-associated fatty liver disease(MAFLD) in order to encompass a more appropriate pathogenesis of the disease.NAFLD was first named to describe a condition similar to alcoholic hepatitis in absence of significant alcohol consumption. However, knowledge pertaining to the etiopathogenesis of the disease has evolved over the past four decades. Recent evidence endorses NAFLD as a terminology of exclusion and suggests that it may often leads to misdiagnosis or inappropriate management of patients, particularly in clinical practice. On the other hand, the new definition is useful in addressing hepatic steatosis with metabolic dysfunction, which ultimately covers most of the patients with such illness. Therefore, it seems to be helpful in improving clinical diagnosis and managing high-risk patients with fatty liver disease. However, it is imperative to validate the new terminology at the population level to ensure a holistic approach to reduce the global burden of this heterogeneous disease condition.  相似文献   

20.
目的了解普通人群中非酒精性脂肪性肝病(NAFLD)及代谢综合征(MS)的患病率,探讨MS与NAFLD发生的关系。方法选择我院体检的普通人群共2374例,B超检查诊断脂肪肝,检测腰围、体重指数(BMI)、血压、丙氨酸氨基转氨酶、尿酸、血脂、空腹血糖(FBG)等指标,分析NAFLD和MS的患病率及MS相关组分与NAFLD的关系。结果共502人诊断为NAFLD,NAFLD患病率21.15%,男性高于女性。NAFLD组代谢综合征患病率50.4%,较对照组明显升高(P=0.001)。Logistic回归分析结果显示,NAFLD危险因素前三位分别是甘油三脂、FBG、BMI。结论普通人群中NAFLD的患病率呈上升趋势,NAFLD患者代谢综合征的患病率明显升高。  相似文献   

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