原发性高血压伴发非酒精性脂肪性肝病的多代谢异常

目的 探讨原发性高血压（EH）患者伴发非酒精性脂肪性肝病（NAFLD）的患病率和多代谢异常的关系.方法 选取EH患者2 218例和非EH健康体检者942例,通过询问病史和腹部B超检查筛查NAFLD,观察其NAFLD患病率、血清丙氨酸氨基转移酶异常的比例及其与血糖、血脂异常、高尿酸血症等多代谢异常的关系.结果 EH患者的NAFLD发生率为37.3％ （942/2 218）.EH伴NAFLD患者糖尿病和代谢综合征发生率、BMI、超重率、血清总胆固醇、三酰甘油、丙氨酸氨基转移酶均高于不伴NAFLD患者（P均＜0.05）,高密度蛋白胆固醇低于不伴NAFLD患者（P＜0.05）.不伴NAFLD患者BMI、超重率、血尿酸水平、血清三酰甘油、丙氨酸氨基转移酶均高于健康对照组（P均＜0.01）.多因素Logistic回归分析表明,糖尿病、血清总胆固醇、血尿酸水平、BMI是EH患者伴发NAFLD的独立危险因素.结论 EH伴NAFLD与血脂、血尿酸等多代谢异常密切相关.

Cross-sectional study of multiple metabolic disorders in patients with essential hypertension and non-alcoholic fatty liver disease

Objective To investigate the incidence of no~n-alcoholic fatty liver disease（NAFLD） in essential hypertension patients and the relation between NAFLD and multiple metabolic disorders. Methods 2 218 patients with essential hypertension and 942 healthy were enrolled into this study. All patients had ultrasound screening for fatty liver. The prevalence of NAFLD, serum alanine aminotransferase abnormality ratio, the relationship between NAFLD and multiple metabolic abnormalities including glu- cose, dyslipidemia, hyperuricemia. Multiple Logistic regression was used to analyze the risk factors of EH with NAFLD. Results Among 2 218 recruited patients, 37.3 % （942/2218 ） had fatty liver by uhrasonog- raphy. In EH co-existed with NAFLD group, the prevalence of diabetes mellitus, metabolic syndrome, over- weight and the levels of BMI ,TC ,TG, ALT were significantly higher than those in the non-NAFLD group （P 〈0.05）. The level of HDL-C was significantly lower than that in the non-NAFLD group（P 〈0.05）. In non-NAFLD group, prevalence of overweight and the levels of BMI, TC, TG, ALT were significantly higher than those in non-EH group（ P 〈 0.01 ）. By muhivariable Logistic regression analysis, diabetes mellitus, hypercholesteremia,hyperuricemia and BMI were risk factors in NAFLD patients with essential hy- pertension. Conclusion NAFLD was more prevalent in patients with EH complicated with multiple meta- bolic disorders, such as hyperlipemia and hyperuricemia.