医院健康查体人群非酒精性脂肪肝危险因素的病例对照研究

摘要：目的探讨天津市健康体检人群非酒精性脂肪肝（NAFLD）发病的危险因素。方法采用病例一对照的方法，分析100例符合诊断标准的非酒精性脂肪肝患者和100例明确除外NAFLD的正常对照的体检结果及其生活方式等影响因素，应用单因素及多因素非条件Logistic回归分析进行统计处理。结果单因素分析显示，NAFLD的发生与体质指数（BMI）、腰围、腰臀比（wHR）、空腹血糖（FBG）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）、极低密度脂蛋白胆固醇（VLDL-C）、丙氨酸转氨酶（ALT）、脐旁、肱三头肌和肩胛皮褶厚度、餐馆就餐频率、夜宵频率、出行方式、体育运动、体重改变、坚果、高血压和糖尿病病史有关。除去与运动存在交互作用的BMI和与脐旁皮褶厚度存在交互的WC后，多因素Logistic回归分析表明，脐旁皮褶厚度（OR=6．68，95％CI：2．38—18．77）、高血压（oR=16．72，95％CI：3．65—76．6z）、体重明显增加（OR=16．75，95％CI：3．11—90．15）、三酰甘油（0R=4．91，95％口：1．89～12．75））、出行方式（OR=0．09，95％CI：0．023～0．369）P2及偶尔食用坚果（OR=O．127，95％CI：0．02～0．79）与NAFLD独立相关。结论脐旁皮褶厚度、高血压、三酰甘油、体重明显增加是NAFLD发生的独立危险因子，步行或骑车的出行方式、偶尔食用坚果是NAFLD的独立保护因素。

Case-control Study on the Risk Factors of Nonalcoholic Fatty Liver Disease Based on Physical Examination People in Hospital

Objective To investigate the risk factors of nonalcoholic fatty liver disease （NAFLD） in physical examination people in Tianjin. Methods The medical examination results and life style of 100 cases and 100 controls were collected to be analyzed by case-control study. The univariate analysis was used to screen out the possibly significant risk factors, then,the forward Logistic regression analysis was applied to identify the independent risk factors. Results The risk factors of NALFD by univariate analysis were BMI, WHR, GLU, TG, HDL-C, VLDL-C, ALT, periumbilical subcutaneous fat thickness, triceps brachii muscle subcutaneous fat thickness, scapular subcutaneous fat thickness, frequency of restaurant dining, frequency of food taken late at night, travel mode, sports, weight increasing, nuts intake, hypertension and diabetes. The multivariate Logistic regression showed that periumbilical subcutaneous fat thickness （OR=6.68, 95%CI： 2.38-18.77）, hypertension （OR=16.72, 95%CI： 3.65-76.62）, weight increase （OR=16.75, 95%CI： 3.11 -90.15）, occasional consumption of nuts （OR=0. 127, 95%CI： 0.02-0.79）, TG（OR=4.91, 95%CI： 1.89-12.75）, travel mode（OR=0.09, 95%CI： 0.023-0.369） were the independent factors for NAFLD. Conclusion Periumbilical subcutaneous fat thickness, hypertension, TG and significant Weight increasing are independent risk factors for NAFLD, occasional consumption of nuts, walking or cycling way to get around are independent protective factors.