老年非酒精性脂肪肝与糖代谢异常的相关性分析

目的 分析中老年人群非酒精性脂肪肝（NAFLD）与糖代谢异常的相关性及发生糖代谢异常的相关危险因素.方法 体检中心423例既往无糖尿病病史的中老年人群（＞50岁）,通过B超筛查分为非酒精性脂肪肝组（NAFLD）和对照组.两组人群均记录相关病史,测量身高、体质量、腰围、臀围、血压,采血检测空腹血糖、血脂等生化指标,并检测75 g葡萄糖负荷后2h血糖,计算体质量指数（BMI）、腰臀比（WHR）;采用Logistic回归分析NAFLD与糖代谢异常的相关性.结果 NAFLD组的BMI、WHR、收缩压（SBP）、舒张压（DBP）、ALT、AST、UA、FBG、P2hBG、TG、TC水平明显高于非NAFLD组（P＜0.05）,而HDL-C水平低于对照组（P＜0.05）;高血压、脂代谢异常、糖代谢异常及代谢综合征的检出率也明显高于对照组（P＜0.001）.Logistic回归分析显示,NAFLD与糖代谢异常呈独立正相关（OR=1.86,95％CI为1.51～2.28,P＜0.001）,TG、ALT、WHR也与糖代谢异常独立相关.结论 中老年人群NAFLD与糖代谢异常表现独立正相关;而TG、WHR与糖代谢异常发生密切相关.

Research on the relationship between nonalcoholic fatty liver disease and various glucose profiles in elderly population

Objective To explore the relationship between nonalcoholic fatty liver disease （NAFLD） and various glucose profiles, and the risk factors of impaired glucose metabolism in elderly population. Methods A total of 423 population without prior known diabetes mellitus were divided into two groups： NAFLD group and without NAFLD group, matched for sex and age. Results The people with NAFLD had higher body mass index, waist-to-hip ratio （WHR）, systolic blood pressure, dias- tolic blood pressure, ALT, AST, UA, FBG, P2hBG, TG and TC than the people without NAFLD （P~0.05）. However, the people with NAFLD had lower HDL-C （P~0.05）. The incidences of hypertension, dyslipidemia, impaired glucose profiles and metabolic syndrome in NFALD group were higher. By logistic regression analysis, NAFLD independently predicted im- paired glucose metabolism （OR= 1.86, 1.51~2.28, P~0. 001） after adjustment for all potential confounders. Moreover, tri- glyceride, ALT and WHR were also associated with impaired glucose profiles. Conclusions These results suggest that NAFLD is associated with impaired glucose profiles independen of multiple metabolic abnormalities in elderly population. Triglyceride, ALT and WHR may paly a certain role in occur and progress of impaired glucose metabolism.