腰臀比和体重指数与非酒精性脂肪肝的相关性研究

目的探讨长沙市某单位职工人群腰臀比值、体重指数与非酒精性脂肪肝(NAFLD)等危险因素的相关性及流行病学特征。方法选择2006年4-12月长沙市某单位职工人群3872例进行健康体检,测量身高、体重、腰围、臀围、血压、血脂、血糖、肝功等指标,并按腰臀比值、体重指数进行分组,分析各组与NAFLD肥胖、高脂血症、高血压、高血糖等危险因素的相关性及流行病学特征。结果受检者肥胖、超重、中心型肥胖、高脂血症、高血压、高血糖、NAFLD的患病率分别为37.8%、25.4%、39.0%、43.1%、23.9%、6.7%、25.3%。中心型肥胖组(按WHR分型)和外周型肥胖组(按BMI分型)NAFLD的患病率明显高于正常体型和正常体重组。中心型肥胖与外周型肥胖与NAFLD的患病率呈正相关。结论长沙市某单位职工人群以肥胖、高血脂、高血压、高血糖等表现为特征的NAFLD的患病率明显增高,尤其是高脂血症值得关注。肥胖、高脂血症是诱发高血压、高血糖导致NAFLD的独立危险因素,中心型肥胖比外周型肥胖危险性更大。腰臀比值与体重指数都可作为NAFLD的危险预测因素,腰臀比值比体重指数特异性更高,两者结合可明显提高NAFLD风险预测的特异性和敏感性。

Correlation Between Nonalcoholic Fatty Liver Disease With Waist to Hip Ratio and Body Mass Index

Objective To discuss the relationship and the epidemiological characteristics between waist to hip ratio(WHR), body mass index (BMI) and nonalcoholic fatty liver disease (NAFLD) among the employees of an enterprise in Changsha. Methods The routine health check up data of 3,782 employees in an enterprise from April to December in 2006 were analyzed. They were stratified into groups according to WHR and/or BMI criteria, and the indexes including body height, weight, waist circumference, hip circumference, blood lipid profiles, blood glucose and blood pressure were checked up. The correlation between WHR and/or BMI with obesity, hyperliponia, hyperglycemia, hypertension and the epidemiological characteristics of NAFLD were analyzed. Results The prevalence of obesity was 37.8%, overweight 25.4%, abdominal adiposity 39.0%, hyperliponia 43.1%, hypertension 23.9%, hyperglycemia 6.7%, and NAFLD 25.3%. The prevalence of NAFLD in abdominal adiposity group (divided according to WHR) and visceral adiposity group (divided according to BMI) was significantly higher than that in normal body weight group. Both abdominal adiposity and visceral adiposity were found to be positively correlated with the prevalence of NAFLD. Conclusion The prevalence of NAFLD, especially hyperliponia, in the employees of this enterprise showed a significant increment. Obesity and hyperliponia are the risk factors of NAFLD. Abdominal adiposity is a stronger risk factor as compared with visceral adiposity. The specificity and sensitivity of diagnosing NAFLD would be enhanced by using combing both WHR and BMI.