高尿酸血症对非酒精性脂肪肝肝损害程度的影响

目的 观察高尿酸血症患者超声诊断非酒精性脂肪肝(NAFLD)的严重程度及肝酶学升高程度,以探索高尿酸血症对NAFLD肝脂肪变的影响.方法 采用1∶1匹配的病例对照研究方法.从我院查体中心2008年1~12月体检者中选取符合诊断标准的624例高尿酸血症患者作为病例组.以病例组为标准,选取性别、工作单位相同,年龄±2岁的体检者作为对照组.测量其身高、体重、血压,空腹取血行肝肾功能、血脂、血糖、肝炎相关检查,同时行心电图、腹部超声、胸部X线等检查.结果 病例组患者BMI、MAP、TC、TG、HDL-C和LDL-C水平及超重或肥胖、FBS增高、血压增高、高TG血症的检出率均显著高于对照组(P<0.05);病例组NAFLD总检出率及轻、中、重度脂肪肝检出率均显著高于对照组(44.9%,26.6%、16.5%和1.8% vs.22.8%,16.0%、6.4%和0.3%;P<0.001)且在NAFLD患者中,病例组中重度脂肪肝的分布比例显著增高(χ2=5.015,P<0.05);无论是病例组还是对照组,超声诊断NAFLD患者ALT、AST、GGT和ALP水平均显著高于超声诊断正常肝组(P<0.05),病例组超声诊断正常肝组患者ALT水平高于相应对照组(P<0.01);病例组NAFLD患者ALT、AST、GGT水平显著高于对照组NAFLD患者(t=33.615、20.971、31.281;P<0.01),在NAFLD患者中,病例组NAFLD患者ALT、AST和GGT升高的检出率显著高于对照组NAFLD患者(χ2=25.352、6.170和45.124;P<0.05).结论 高尿酸血症是NAFLD进展的重要高危因素,与超声诊断脂肪肝的严重程度及肝酶学异常密切相关.

The effect of hyperuricemia on severity of nonalcoholic fatty liver disease

Objective To survey the severity of liver fatty diagnosed by ultrasound and the change of liver enzymes in patients with hyperuricemia,so as to explore the effect of hyperuricemia on severity of liver fatty disease.Methods 1:1 matched case-control was used for this study.624 patients with hyperuricemia as the case group,and gender,unit and age(±2 years)matched controls were recruited from medical centers for health examination,from January to December in 2008.Height,weight,blood pressure,blood lipids,blood sugar,hepatitis-related markers,and abdominal color Doppler ultrasound examination were conducted in the fasting state.Results The level of BMI,MAP,TC,TG,HDL-C and LDL-C and the detection rate of overweight or obese,hyperglycaemia,hypertension,hypertriglyceridemia were significantly higher in case group than those in control group(P<0.05 or 0.001).The detection rate of NAFLD were significantly higher in case group than those in control group for total,mild,moderate and severe fatty liver(44.9%,26.6%,16.5% and 1.8% vs.22.8%,16.0%,6.4% and 0.3%;P<0.001).Of patients with NAFLD,the distribution proportion of moderate and severe fatty liver was significantly higher in case group than than control group(χ2=5.015,P<0.05).Both these two groups,the level of ALT,AST,GGT and ALP levels were significantly higher in patients with NAFLD than those without NAFLD diagnosed by ultrasound(P<0.05 or 0.01).In people without NAFLD,the level of ALT were higher in case group than in control group(P<0.01).The level of ALT,AST,GGT were significantly higher in case group than control group,and of patients with NAFLD(t=33.615,20.971,31.281;P<0.01),the detection rate of increased ALT,AST and GGT significantly higher in case group than control group(χ2=25.352,6.170 and 45.124;P<0.05 or 0.01).Conclusions Hyperuricemia is the essential risk factors of the progress of NAFLD and closely related to the severity of the fatty liver ultrasound diagnosed by ultrasound and abnormal liver enzymes.