健康体检人群糖化血红蛋白水平与非酒精性脂肪肝的相关性

目的：探讨健康体检人群中非酒精性脂肪肝与糖化血红蛋白(glycosylated hemoglobin，HbA1c)的关系。 方法：选取符合入选条件的香港大学深圳医院体检中心2013年6月至11月的912名健康体检者作为研究对象，分为非 酒精性脂肪肝组、其他肝病组和对照组，对其体检结果进行回顾性分析。结果：非酒精性脂肪肝患病率为29.7%； 非酒精性脂肪肝组的年龄、体重指数、收缩压、舒张压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、空腹血糖、 HbA1c及谷丙转氨酶均高于其他肝病组和对照组(P<0.05)，谷草转氨酶高于对照组(P<0.05)，高密度脂蛋白胆固醇则 低于其他肝病组和对照组(P<0.05)；根据HbA1c水平的四分位数进行分层，分为Q1~Q4组，Q1，Q2，Q3及Q4组非 酒精性脂肪肝患病率分别为17.5%，21.5%，31%及59.4%，随着HbA1c水平的增高非酒精性脂肪肝的患病率逐渐增高 (χ2=100.092，P<0.05)；logistic回归分析结果显示在校正年龄、性别、体重指数等因素后，Q4组的非酒精性脂肪肝患 病风险仍高于Q1组。结论：非酒精性脂肪肝患病率与HbA1c水平呈正相关，随着HbA1c水平的增加而增高，高HbA1c 水平可能是非酒精性脂肪肝患病的一个独立危险因素，应将其列为健康体检常规检查项目。

Association between glycosylated hemoglobin and non-alcoholic fatty liver disease in health examination population

Objective: To investigate associations between glycosylated hemoglobin (HbA1c) levels and nonalcoholic fatt y liver disease (NAFLD) in population who underwent periodic heath examination. Methods: A total of 912 subjects were selected from the health examination adults in University of Hong Kong Shenzhen Hospital from June to November 2013, and they were assigned into a NAFLD group, an else hepatic disease group, and a control group. The physical examination results of these subjects were analyzed retrospectively. Results: The prevalence of NAFLD was 29.7%. The related factors such as age, body mass index, and the levels of systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, fasting glucose, HbA1c and alanine aminotransferase in the NAFLD group were higher than those in the else hepatic disease group and the control group (P<0.05). Aspartate aminotransferase levels in the NAFLD group were higher than those in the control group (P<0.05). High density lipoprotein cholesterol levels in the NAFLD group were lower than those in the else hepatic disease group and the control group (P<0.05). According to the quartile of HbA1c level, these subjects were divided into 4 groups, Q1, Q2, Q3, and Q4, and the prevalence of NAFLD in the Q1,Q2, Q3, and Q4 were 17.5%, 21.5%, 31%, and 59.4%, respectively. The prevalence of NAFLD increased along with the increase in the level of HbA1c (χ2=100.092, P<0.05). Logistic regression analysis showed that the risk factor for NAFLD was increased in the subjects of Q4 as compared with the subjects of Q1 after adjusting for the related factors including age, gender, body mass index, etc. Conclusion: There is a positive correlation between the prevalence of NAFLD and HbA1c level, and the risk of NAFLD increases with the elevating level of HbA1c. High HbA1c level is an independent risk factor for NAFLD. Thus it should be listed as a routine medical test in the health examination.