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目的探讨非高密度脂蛋白胆固醇(non-HDL-C)水平与新疆维吾尔族绝经后女性非酒精性脂肪性肝病(NAFLD)的关系。方法选取2014年7月-2015年8月在新疆乌鲁木齐市第一附属医院和新疆喀什地区第一人民医院体检中心健康体检的1271例绝经后维吾尔族女性为研究对象,以是否患有NAFLD将其分为NAFLD组(682例)和对照组(589例),详细测量并记录研究对象人口学资料并测定肝脏酶学指标、糖脂代谢、尿酸及non-HDL-C等指标。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,采用非条件Logistic回归分析影响绝经后女性发生NAFLD的危险因素。结果 NAFLD组血清尿酸、空腹血糖、甘油三酯(TG)、糖化血红蛋白、ALT、AST、腰围、臀围、BMI、腰臀比、non-HDL-C水平均高于对照组,差异均有统计学意义(P值均<0.05);而HDL-C与脂联素水平较对照组低,差异均有统计学意义(P值均<0.05)。non-HDL-C<3.58 mmol/L组空腹血糖、总胆固醇、TG、AST、ALT、低密度脂蛋白胆固醇水平显著低于non-HDL-C≥3.58 mmol/L组,差异均有统计学意义(P值均<0.05)。多因素Logistic回归分析显示,non-HDL-C、血清尿酸和BMI是绝经期女性NAFLD的危险因素。结论除了向心性肥胖、高甘油三酯血症、高尿酸血症是NAFLD的危险因素外,non-HDL-C水平亦是绝经后女性患非酒精性脂肪肝的主要危险因素。
Objective To investigate the relationship between non-HDL-C level and non-alcoholic fatty liver disease (NAFLD) in Uygur nationality in Xinjiang Uygur. Methods A total of 1271 postmenopausal Uyghur women from the First Affiliated Hospital of Urumqi and the First People’s Hospital of Kashgar Prefecture in Xinjiang from July 2014 to August 2015 were selected to study whether they had NAFLD or not The patients were divided into NAFLD group (682 cases) and control group (589 cases). The demographic data of the study subjects were measured and recorded. The indexes of liver enzymology, glucose and lipid metabolism, uric acid and non-HDL-C were measured. The t test was used to compare the measurement data. The chi-square test was used to compare the data between groups. Non-conditional logistic regression analysis was used to analyze the risk factors of NAFLD in postmenopausal women. Results The levels of serum uric acid, fasting blood glucose, triglyceride, glycosylated hemoglobin, ALT, AST, waist circumference, hip circumference, BMI, waist-hip ratio and non-HDL-C in NAFLD group were significantly higher than those in control group (P <0.05). However, the levels of HDL-C and adiponectin were lower than those of the control group (all P <0.05). The levels of fasting blood glucose, total cholesterol, TG, AST, ALT and LDL-C in non-HDL-C <3.58 mmol / L group were significantly lower than those in non-HDL-C≥3.58 mmol / L group (P <0.05). Multivariate Logistic regression analysis showed that non-HDL-C, serum uric acid and BMI were risk factors for NAFLD in postmenopausal women. Conclusions In addition to central obesity, hypertriglyceridemia and hyperuricemia are risk factors for NAFLD, non-HDL-C levels are also a major risk factor for nonalcoholic fatty liver disease in postmenopausal women.