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目的:分析上海市社区60~75岁老年人非酒精性脂肪性肝病（NAFLD）的相关危险因素，为社区预防和治疗老年NAFLD提供依据。方法:采用病例对照的研究方法。连续纳入2016年3月9日至2018年3月8日在上海市嘉定区江桥社区卫生服务中心全科门诊就诊的60~75岁NAFLD患者1 894例作为研究组。连续纳入同期与研究组性别、年龄匹配的无NAFLD老年患者1 894例为对照组，收集两组患者性别、年龄、吸烟、BMI、腰围、血压、血生化等指标，询问合并疾病史。采用χ2检验、n t检验进行单因素分析，并对NAFLD的影响因素进行多因素logistic回归分析。n 结果:（1）与对照组比较，研究组BMI、腰围、心率、舒张压均高于对照组［（27±3）比（24±3）kg/mn 2，n t=26.139；（89±8）比（82±8）cm，n t=24.398；（75±11）比（74±11）次/min，n t=2.370；（87±10）比（85±10）mmHg（1 mmHg=0.133 kPa），n t=7.898］，差异均有统计学意义（均n P<0.05）。（2）研究组空腹血糖、糖化血红蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、血尿酸、总胆固醇、甘油三酯、低密度脂蛋白胆固醇均高于对照组［（5.9±2.0）mmol/L比（5.3±1.5）mmol/L，n t=10.438；（6.2±1.2）%比（5.9±0.9）%，n t=11.654；（24±16）mmol/L比（18±15）mmol/L，n t=11.915；（23±11）mmol/L比（22±13）mmol/L，n t=4.300；（342±84）mmol/L比（307±80）mmol/L，n t=13.189；（5.3±1.1）mmol/L比（5.1±1.0）mmol/L，n t=6.073；1.71（1.29，2.35）mmol/L比1.17（0.91， 1.57）mmol/L，n Z=37.261； （3.4±0.9）mmol/L比（3.2±0.9）mmol/L，n t=6.984］，血肌酐、高密度脂蛋白胆固醇均低于对照组［（70±17）mmol/L比（71±18）mmol/L，n t=-2.712；（1.3±0.3）mmol/L比（1.5±0.4）mmol/L，n t=-16.726］，差异均有统计学意义（均n P<0.01）。（3）研究组合并高血压病、2型糖尿病、代谢综合征的比例均高于对照组［53.8%（1 019/1 894）比43.4%（822/1 894），χ2n =41.013；16.7%（317/1 894）比11.3%（214/1 894），χ2n =23.237；48.3%（915/1 894）比18.0%（341/1 894），χ2n =392.446］，差异均有统计学意义（均n P<0.01）。（4）Logistic回归分析显示，60~75岁女性（n OR=2.348，95%n CI：1.917~2.876）、高BMI（n OR=1.143，95%n CI：1.099~1.189）、甘油三酯升高（n OR=1.894，95%n CI：1.716~2.09）、低密度脂蛋白胆固醇升高（n OR=3.066，95%n CI：2.359~3.983）和糖化血红蛋白升高（n OR=1.276，95%n CI：1.175~1.386）等13项因素可能是NAFLD发生的危险因素（均n P<0.01）。n 结论:影响NAFLD的因素复杂，全科医生应针对上述危险因素采取相应的防治措施，以减少NAFLD的发生发展。“,”Objective:To analyze the risk factors of non-alcoholic fatty liver disease (NAFLD) among elderly residents in the community.Methods:A total of 1 894 patients aged 60-75 years with NAFLD visiting general practice clinic from March 2016 to March 2018 were enrolled in the study; 1 894 age and sex-matched subjects without NAFLD served as the control group. The data of gender, age, smoking status,body mass index (BMI), waist circumference, blood pressure, blood biochemistry,past medical history and other clinical and laboratory testing were collected in the two groups. Multivariate logistic regression analysis was performed to explore the related risk factors of NAFLD.Results:The BMI [(27±3) kg/mn 2vs.(24±3) kg/mn 2,n t=-26.139], waist circumference [(89±8) cm n vs.(82±8) cm,n t=-24.398], heart rate [(75±11) bpm n vs. (74±11) bpm, n t=-2.370], and diastolic blood pressure [(87±10) mmHg n vs. (85±10) mmHg(1 mmHg=0.133 kPa),n t=7.898] in the NAFLD group were significantly higher than those in the control group(all n P<0.05). The levels of fasting blood glucose (FBG) [(5.9±2.0)mmol/L n vs. (5.3±1.5) mmol/L,n t=10.438], glycated hemoglobin (HbA1c) [(6.2±1.2)% n vs. (5.9±0.9)%,n t=11.654], alanine aminotransferase (ALT)[(24±16) mmol/L n vs. (18±15) mmol/L,n t=11.915], aspartate aminotransferase (AST) [(23±11) mmol/L n vs.(22±13) mmol/L,n t=4.300], blood uric acid (UA) [(342±84) mmol/L n vs. (307±80) mmol/L,n t=13.189], total cholesterol (TC) [(5.3±1.1) mmol/L n vs. (5.1±1.0) mmol/L,n t=6.073], triglycerides (TG)[1.71(1.29,2.35) mmol/L n vs. 1.17 (0.91,1.57) mmol/L,n Z=37.261], and low-density lipoprotein cholesterol (LDL-C)[(3.4±0.9) mmol/L n vs. (3.2±0.9) mmol/L,n t=6.984] in NAFLD group were significantly higher than those in the control group (all n P<0.01); and the levels of blood creatinine (Cr) [(70±17) mmol/L n vs. (71±18) mmol/L,n t=-2.712] and high-density lipoprotein cholesterol (HDL-C) [(1.3±0.3) mmol/L n vs. (1.5±0.4) mmol/L,n t==-16.726] in NAFLD group were significantly lower than those in the control group (all n P<0.01). The proportion of people with hypertension [53.8% (1 019/1 894) n vs. 43.4% (822/1 894)], type 2 diabetes [16.7%(317/1 894) n vs. 11.3%(214/1 894)], metabolic syndrome [48.3% (915/1 894) n vs. 18.0% (341/1 894)] in NAFLD group was significantly higher than that in the control group (χn 2=41.013, 23.237, 392.446, n P<0.01). Logistic regression analyses revealed 13 independent risk factors of NAFLD, including 60-75 years-old female (n OR=2.348, 95n %CI: 1.917-2.876, n P<0.01), high BMI (n OR=1.143, 95n %CI: 1.099-1.189, n P<0.01), elevated TG (n OR=1.894, 95n %CI: 1.716-2.090,n P<0.01), LDL-C (n OR=3.066, 95n %CI: 2.359-3.983, n P<0.01) and HbA1c (n OR=1.276, 95n %CI: 1.175-1.386,n P<0.01).n Conclusion:The factors associated with NAFLD are complicated; and corresponding measures targeting the risk factors should be taken to reduce the occurrence and development of NAFLD among elderly people in the community.