非酒精性脂肪性肝病的血清生化指标和危险因素分析

目的观察分析非酒精性脂肪性肝病（NAFLD）的血清生化指标，结合患者的生活方式，总结探讨诱发该病的危险因素。方法选择门诊和住院确诊的NAFLD患者共258例，同期非脂肪性肝病体检者213例为对照组。分别进行血清生化指标检测和生活习惯调查。结果NAFLD组的生化指标TC（5．48±1．10）mmol／L、TG（2．31±1．25）mmol／L、ALT（51．35±26．18）U／L、AST（42．37±28．32）U／L、空腹血糖（FPG）（5．62±3．24）mmol／L、γ-谷氨酰转肽酶（GGT）（58．47±43．25）U／L、尿酸（UA）（398．51±96．85）μmol／L均高于对照组（t=3．423、5．250、7．402、4．348、3．326、6．683、3．891，均P〈0．01）；高血压（21．71％）、糖尿病（22．09％）、代谢综合征（MS，44．57％）等发生率及BMI（26．85±3．45）均明显高于对照组（χ2=8．14、10．55、58．48，t=10．73，均P〈0．01）。多因素Logistic回归分析中，TG、腰围（WI）、BMI、胰岛素抵抗指数（HOMA-IR）、缺少锻炼、高脂饮食是NAFLD的独立危险因素（均P〈0．05）。结论NAFLD患者与代谢异常密切相关，合理的饮食和健康的生活方式是防治该病的有效途径。

The relationship between biochemical indicators and risk factors of nonalcoholic fatty liver disease

Objective To observe the biochemical indicators and lifestyles of patients with non-alcoholic fatty liver disease （ NAFLD ） , and analyse the risk factors of induced NAFLD . Methods A total of 258 in-andout-patients of NAFLD were included in the present study, the control group consisted of 213 examinationers with non- fatty liver disease. All samples were being blood biochemical indicator detection and lifestyle survey. Results Some blood biochemical index of NAFLD patients such as TC （ 5.48 ± 1. 10 ） mmol/L, TG （ 2.31 ± 1.25 ） mmol/L, ALT （51.35 ±26.18）U/L,AST（42.37 ±28.32） U/L,FPG（5.62±3.24） mmol/L,GGT（58.47 ±43.25） U/L and UA （398.51±96.85 ） μmol/L were higher than those of the control group （ t = 3. 423,5. 250,7. 402,4. 348,3. 326, 6. 683,3. 891, all P 〈 0.01 ） ;and the incidence of hyperlipidemia, hypertension （21.71% ）, diabetes （22.09%）, BMI（26.85 ± 3.45） or metabolic syndrome （44.57%） etc. Those indexes in NAFLD patients were significantly higher than those in the control group （ ~2 = 8.14,10.55,58.48 ,t = 10.73, all P 〈 0.01 ）. By multivariable Logistic regression analysis, TG, WI, BMI, HOMA-IR, lack of exercise, high-fat diet were independent risk factors for NAFLD （all P 〈 0. 05 ）. Conclusion Patients with NAFLD is closely correlated to metabolic abnormalities, reasonable diet and a healthy lifestyle is an effective way of prevention and treatment of this disease.