四川地区中老年体检人群非酒精性脂肪性肝病患病率调查及与代谢相关指标的相关性分析

目的 了解四川地区中老年体检人群非酒精性脂肪性肝病(NAFLD)的患病率及流行现状，分析NAFLD与主要代谢相关指标的相关性。方法 选择2018年1 - 12月在四川省人民医院健康管理中心进行常规健康体检年龄≥45岁的39 496例健康体检者作为研究对象，收集性别、年龄、身高、体重、血压、空腹血糖、血脂、肝功能等体检资料，行肝脏超声检查并计算NAFLD的患病率，分析NAFLD与主要代谢相关指标的相关性。结果 NAFLD总体患病率为32.2%。男性高于女性(37.5% vs 19.2%;χ2 = 1244.850, P＜0.001)；年龄分层后，男性的患病高峰年龄为50～59岁，随着年龄的增加患病率逐渐上升，在60岁之后略有下降(χ2趋势 = 18.442, P＜0.001)；女性的患病高峰年龄为50岁以后，且随着年龄的增加患病率呈明显上升趋势(χ2趋势 = 116.935, P＜0.001)；按BMI分层，男性的患病高峰为BMI＞28.0（kg/m2），随着BMI的增加患病率呈明显的上升趋势(χ2趋势 = 2313.311, P＜0.001)；女性的患病高峰亦为BMI＞28.0（kg/m2），随着BMI的增加患病率明显上升(χ2趋势 = 1285.274, P＜0.001)。多因素Logistic回归分析显示:肥胖症、高胆固醇血症、混合型高脂血症、ALT异常和AST异常与NAFLD患病之间存在明显正相关，是中老年体检人群NAFLD患病的独立代谢相关危险因素(均P＜0.05)。结论 四川地区中老年体检人群的NAFLD患病率较高，男性高于女性，患病高峰年龄为50～59岁，肥胖患者患病风险更高，肥胖症、高胆固醇血症、混合型高脂血症、ALT异常和AST异常可能是NAFLD患病的独立代谢相关危险因素。

Prevalence of non-alcoholic fatty liver disease and its correlation with metabolic factors in middle-aged and elderly physical examination population in Sichuan area

The aim of this study was to investigate the prevalence of non-alcoholic fatty liver disease in middleaged and elderly people in Sichuan area, and thus to analyze the correlation between NAFLD and major metabolic indicators.Methods A total of 39 496 individuals aged 45 and over were selected as observed subjects from January to December 2018 in Health Management Center of Sichuan Provincial People’s Hospital. The physical examination data of sex, age, height,weight, blood pressure, fasting blood glucose, blood lipid, liver function were collected. Liver ultrasound examination were carried out and the prevalence of NAFLD were calculated. The correlation between NAFLD and main metabolic related indicators were analyzed. Results The overall prevalence of NAFLD was 32.2%. The prevalence of NAFLD in males was higher than that in females(37.5% vs 19.2%; χ2=1244.850, P<0.001). The peak age of NAFLD in males was 50-59 years old after age stratification, which gradually increased with age, and decreased slightly after 60 years old(χ2 trend=18.442, P<0.001).The peak age of NAFLD in females was after 50 years old and with age. Increased prevalence showed a significant upward trend(χ2 trend=116.935, P <0.001). After stratification according to BMI, the prevalence peak of male was BMI > 28.0, and increased with the increasing BMI(χ2 trend=2313.311, P <0.001). The prevalence peak of female was BMI >28.0, and the prevalence increased with the increasing BMI(χ2 trend=1285.274, P<0.001). Multivariate logistic regression analysis showed that obesity, hypercholesterolemia, mixed hyperlipidemia, ALT abnormality and AST abnormality were positively correlated with NAFLD, and they were independent metabolic risk factors for NAFLD in middle-aged and elderly physical examination population(all P<0.05). Conclusion The prevalence of NAFLD was high in middle-aged and elderly people in Sichuan area.The prevalence of NAFLD in male was higher than that in female. The peak age of NAFLD was 50-59 years old. Obesity,hypercholesterolemia, mixed hyperlipidemia, ALT abnormality and AST abnormality were independent metabolic risk factors for NAFLD.