老年非酒精性脂肪性肝病相关危险因素分析

目的探讨老年非酒精性脂肪性肝病(NAFLD)发生的相关危险因素。方法采用回顾性横断面调查方法,选取2015年1月至2017年3月首都医科大学附属北京友谊医院医疗保健中心内科接收的年龄为65~101岁的663名体检人群。根据NAFLD诊断标准,将所有研究对象分为NAFLD组(n=242)和非NAFLD组(n=421)。比较NAFLD组和非NAFLD组人群的血清25-羟维生素D水平,以及不同年龄组[65≤年龄<70岁,n=71;70≤年龄<75,n=88;75≤年龄<80,n=117;80≤年龄<85,n=152;85≤年龄<90,n=126;年龄≥90,n=109]的NAFLD患病率及25-羟维生素D水平的差异。采用Logistic回归分析法分析老年NAFLD的相关危险因素。结果两组人群的性别构成比、年龄、转氨酶(AST)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、超敏C反应蛋白(h-CRP)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平比较,差异均无统计学意义(P>0.05)。与非NAFLD组相比,NAFLD组有更高的身体质量指数(BMI)、丙氨酸氨基转移酶(ALT)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、总甘油三酯(TG),差异具有明显统计学意义(P<0.001)。Logistic回归分析提示,老年NAFLD与25-羟维生素D、FT4呈负相关,与HbA1c、TG、ALT、BMI、FT3呈正相关。结论低水平维生素D是老年NAFLD的独立危险因素之一。BMI、Hb A1c、TG、FT3是老年NAFLD的其他危险因素。

Analysis of risk factors related to nonalcoholic fatty liver disease in Chinese elderly

Objective To analyze the risk factors associated with nonalcoholic fatty liver disease(NAFLD)in the Chinese elderly.Methods The retrospective cross-sectional study selected 663 patients(aged 65~101 years old)who received physical examination in the Internal Medicine Department Medical Healthcare Center,Beijing Friendship Hospital,Capital Medical University from January 2015 to March 2017.According to the diagnostic criteria of NAFLD,the patients were divided into NAFLD group(n=242)and non-NAFLD group(n=421).According to their age,patients were divided into different age groups:65≤age<70 years old,n=71,70≤age<75 years old,n=88;75≤age<80 years old,n=117;80≤age<85 years old,n=152;85≤age<90 years old,n=126;age≥90 years old,n=109.Age,gender,body mass index(BMI),fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),transaminase(AST and ALT),uric acid(UA),hypersensitive C-reactive protein(hs-CRP),free triiodothyronine(FT3),free thyroxine(FT4),human thyroid stimulating hormone(TSH)and 25-hydroxy vitamin D were compared between NAFLD group and non-NAFLD group.The morbidity and level of 25-hydroxy vitamin D were compared among different age groups.Logistic regression was used to analyze the risk factors associated with NAFLD elderly.Results There was no significant difference in age,gender,AST,TC,HDL-C,LDL-C,UA,h-CRP,FT3,FT4 and TSH between two groups.Compared with the non-NAFLD group,BMI,ALT,FBG,HbA1c,TG in the NAFLD group were higher(P<0.001).Logistic regression analysis indicated that elderly NAFLD was negatively correlated with25-hydroxyvitamin D and FT4,and positively correlated with Hb A1 c,TG,ALT,BMI and FT3.Conclusion Low level of vitamin D was one of the independent risk factors for elderly NAFLD.BMI,Hb A1 C,TG,FT3 are other risk factors for elderly NAFLD.