非酒精性脂肪肝与冠心病的发病风险

目的 对非酒精性脂肪肝(NAFL)患者5 年和10 年后发生冠心病的风险进行量化评估.方法 选择178 例30～74 岁、无心血管疾病史的NAFL 患者和178 例年龄、性别匹配、冠心病危险因素相似的对照人群,收集年龄、性别、体重指数、动脉收缩压、总胆固醇、高密度脂蛋白胆固醇、吸烟习惯、是否有糖尿病、高血压和NAFL 等信息,计算并比较两组间5 年和10 年Framingham 冠心病风险评分,采用Logistic 回归法分析使NAFL 患者10 年Framingham 冠心病风险级别增高的独立危险因素.结果 NAFL 患者5 年Framingham 冠心病风险评分与对照组比较(3.69±0.28) % vs (3.23±0.22) %],差异无统计学意义(t =1.99,P＞0.05);10 年冠心病风险评分明显高于对照组(10.34±0.69) % vs (4.97±0.73) %],差异有统计学意义(t =9.93,P＜0.05).使NAFL 患者冠心病风险级别增高的独立危险因素有高血压(OR:11.09,95% CI:3.03～37.38,P＜0.05)、吸烟(OR:13.84,95% CI:2.92～63.47,P＜0.05)、总胆固醇＞200 mg/dl(OR:7.18,95% CI:2.35～22.15,P＜0.05)和高密度脂蛋白胆固醇＜50 mg/dl(OR:3.68,95% CI:1.46～10.73,P＜0.05).结论 NAFL 患者10 年冠心病风险明显增加,高血压、吸烟和胆固醇水平异常是冠心病风险增高的独立危险因素.

Non-alcoholic fatty liver and risk of developing coronary heart disease

Objective To quantitatively evaluate the absolute risk of developing coronary heart disease （CHD） at 5 and 10 years in patients with non-alcoholic fatty liver （NAFL）. Methods One hundred and seventy-eight NAFL patients aged 30 to 74 years and without prior cardiovascular diseases and 178 age- and gender-matched subjects with similar risk factors of coronary heart disease were enrolled, information including age, gender, body mass index, systolic blood pressure, total cholesterol （TC） and high density lipoprotein cholesterol（HI）L-c）, status of smoking, diabetes, hypertension and NAFL were collected. The 5-year and lO-year Framingham Risk Score for CHD weie calculated and compared between the two groups; independent factors involving in an increase of the level of 10-year Framingham Risk Score for CHI） in NAFL patients were analyzed by Logistic regression analysis. Results In comparison with controls, there was no significance in 5-year Framingham Risk Score for CHD （3.69±0.28） % vs （3.23±0.22） %; t =1.99,P〉0.05 ], however, 10-year Framingham Risk Score were significantly increased in NAFL patients （10.34±0.69） %vs（4.97±0.73） %; t=9.93, P〈0.05]. Independent risk factors that increased the risk of developing CHD in NAFL subjects were hypertension （OR： 11.09, 95% CI：3.03-37.38, P〈0.05）, smoking （OR： 13.84, 95% CI：2.92-63.47, P〈0.05）, TC〉200 mg/dl （OR：7.18, 95% CI ： 2.35-22.15, P〈0.05） and HDL-c〈50mg/dl （OR： 3.68, 95% CI- 1.46-10.73, P〈0.05）. Conclusions NAFL increases 10-year risk of developing CHD; hypertension, smoking, abnormal cholesterol level are independent factors that upgrade risk level of developing CHI）.