非酒精性脂肪肝患者肝损害程度与代谢综合征各组分的关系

目的 探讨非酒精性脂肪肝（NAFLD）患者不同肝损害程度与代谢综合征（MS）各组分之间的关系.方法 1151例NAFLD患者以及年龄、性别相匹配的4113例健康对照人群均来自我院体检中心.所有研究对象均进行身高、体重、血压、血脂、血糖、肝炎系列等指标的检测,空腹行腹部彩超检查.分析并比较检测的各项结果.结果 1151例超声诊断NAFLD患者中轻度767例,中度345例,重度39例,MS检出例数分别为218、144和20例,检出率分别为28.4%、41.7%和51.3%,显著高于健康对照组（7.8%）,且随超声诊断脂肪肝的严重程度逐渐递增（P＜0.01）;ALT正常者905例,升高者246例,其中血脂紊乱、超重或肥胖和MS的检出率分别为54.6%、66.6%、31.9%和71.5%、82.5%、37.8%,均显著高于健康对照组（24.3%、32.4%和7.7%）,且随ALT升高而逐渐递增（P＜0.05）.但NAFLD组高血压、高血糖检出率与健康对照组相比差异无统计学意义（P＞0.05）.结论 NFALD患者肝损害程度与代谢综合征各组分关系密切,尤其与肥胖、血脂紊乱密切相关,因此,应重视NAFLD患者的调脂减肥治疗.

Relation between liver damage and metabolic syndrome in patients with nonalcoholic fatty liver disease

Objective To evaluate the relation between liver damage and metabolic syndrome(MS) in patients with nonalcoholil fatty liver disease (NAFLD). Indexes of height, weight, blood pressure, blood lipids, blood sugar, hepatitis series and abdominal color doppler ultrasound examination were conducted. Methods Total 1151patients with NAFLD and 4113 healthy people matched by age and sex were analyzed. Indexes of height,weight,blood pressure ,blood lipids,blood sugar, hepatitis series and abdominal color Doppler ultrasound examination were conducted. Results Total 767 patients had mild fatty liver, 345 patients had moderate fatty liver and 39 patients had severe fatty liver. The prevalence of MS was respectively 28.4% (218/767 ),41.7% (144/345 ) and 51.3 %(20/39), significantly higher than that in the control group (7.8%) ,and it gradually increased with the severity of sonographic fatty liver. 905 cases with normal ALT level and 246 cases with increased ALT level were detected in 1151 patients with sonographic fatty liver based on ALT test and rates dyslipidemia. The prevalence of overweight or obesity, dyslipidemia and MS was significantly higher in patients with nonalcoholic fatty liver disease than that in healthy controls, and it gradually increased with the increasing of ALT. But there was no significant difference in hypertension and hyperglycemia between nonalcoholic fatty liver disease and healthy control group. Conclusions The nonalcoholic sonographically fatty liver is strongly associated with the components of MS, especially with obesity and dyslipidemia. Measures must be taken to control body weight and to lower lipid in patient with nonalcoholic fatty liver disease.