体检人员脂肪肝患病率及危险因素分析

目的了解温州地区脂肪肝流行特征,对相关危险因素进行分析。方法收集2009年在温州医学院附属第一医院体检中心接受体检的人员,随机选取经B超或CT诊断为脂肪肝患者208例为病例组,随机选取188名无脂肪肝者为对照组,自行设计调查问卷进行调查问卷。相关数据用SPSS 13.0软件包进行处理。结果 4219名体检人员中,脂肪肝患病数为878例,患病率为20.81%,男性患病率大于女性患病率(χ2=248.2,P0.01);脂肪肝随年龄的增加总体呈上升趋势。单因素分析示脂肪肝组超重肥胖、中心性肥胖、高血压、高收缩压、高舒张压、IFG、糖尿病、高甘油三酯血症、高胆固醇血症、低HDL-C血症、高ALT血症、高尿酸血症、代谢综合征、腰臀比超标高于非脂肪肝组。多因素Logistic回归分析,示腰臀比超标、高血压、超重肥胖、高甘油三酯血症、高ALT为脂肪肝的独立危险因素,而粗粮(≥3次/w)、经常锻炼、天天饮酒为脂肪肝的保护因素。结论温州市体检人员脂肪肝患病率高,肥胖及其相关的多元代谢紊乱与脂肪肝的关系密切。

Survey on the Prevalence and Risk Factors of Fatty Liver among 4219 People in Health Examination

Objective To investigate the prevalence and main risk factors of fatty liver among adults in Wenzhou area. Methods A cress - sectional survey was conducted. The people aged 18 and above who had a physical examination in the First Affiliated Hospital of Wenzhou Medical College in 2009 were taken as the subjects. During the survey, 208 fatty liver subjects diagnosed by ultrasound or CT were randomly sampled as fatty liver group and 188 healthy people were selected as control group. Data analysis was performed by SPSS13.0 software. Results Of 4219 cases, 878 fatty liver patients were detected （20. 81% ）. The prevalence of fatty liver in male was significantly higher than that in female （ χ^2 = 248.2 ,P〈0. 01 ）. The prevalence increased with age. The proportions of overweight, obesity, central obesity, hypertension, high systolic pressure, high diastolic pressure, IFG, diabetes mellitus, hypertriglycefidemia, hypercholesterelemia, low HDL -C, high ALT, hyperuricemia, metabolism syndrome in fatty liver group are significantly higher than those in control group. Multivariate logistic regression analysis indicated that overweight, obesity, hypertriglyceridemia, hypertension, high ALT, waist/hip ratio （male≥0. 9, female≥0. 8） were risk factors for fatty liver, while coarse grain intake （≥3times/w） , alcohol daily and regularity exercises were the protective factors for fatty liver. Conclusion The prevalence of fatty liver among the population carrying out health examination in Wenzhou area is high. Metabolic disorders such as obesity are closely associated with fatty liver.