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目的分析长春地区健康体检人群中非酒精性脂肪肝(NAFLD)的患病率及危险因素。方法选取2015年2月至2016年4月在吉林省人民医院体检中心初次进行体检且接受肝脏B型超声检查的3154例体检人群作为研究对象,其中无原发性肝病、药物性肝病和嗜酒饮酒(酒精量:男>40 g/d,女>20 g/d)的体检者3108例。将符合NAFLD诊断标准的992例作为NAFLD组,2116例非NAFLD的健康体检者作为对照组。统计所有研究对象的性别,常规测量血压、体重并计算体重指数(BMI);采集空腹静脉血,检测空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸水平。统计健康体检者的NAFLD患病率,分析不同性别、年龄健康体检者NAFLD患病率,比较两组研究对象的BMI、血压、FPG、血脂及血尿酸水平,并进行非条件Logistic回归分析。结果检出NAFLD 992例,NAFLD的患病率为29.7%;随年龄增长,男女的NAFLD患病率均呈上升趋势;50岁前男性NAFLD患病率均明显高于女性,差异均有统计学意义(均P<0.05),50~60岁男女NAFLD患病率比较,差异无统计学意义(P>0.05);NAFLD组患者的BMI、收缩压(SBP)、舒张压(DBP)、FPG、TC、TG、LDL-C及血尿酸均明显高于对照组,H-DLC明显低于对照组,差异均有统计学意义(均P<0.05);非条件Logistic回归分析结果显示,性别、BMI、SBP、DBP、FPG、TC、TG、L-DLC、H-DLC、血尿酸均是导致NAFLD发生的危险因素。结论男性是NAFLD的高危人群,减轻体重及维持正常的血压、血糖、血脂、血尿酸水平,增强市民的保健意识,定期体检,早期筛查,积极预防NAFLD发生,有助于降低人群中脂肪肝的患病率。
Objective To analyze the prevalence and risk factors of nonalcoholic fatty liver disease (NAFLD) in health examination population in Changchun area. Methods From March 2015 to April 2016, 3154 medical examination subjects, who underwent physical examination at the Physical Examination Center of Jilin Province People’s Hospital for the first time and who underwent liver B-mode ultrasonography, were selected as the research subjects. Among them, no primary liver disease, drug-induced liver disease and alcohol abuse 3108 cases of alcohol abuse (alcohol content: male> 40 g / d, female> 20 g / d). A total of 992 NAFLD patients and 2116 non-NAFLD healthy controls were enrolled as control group. The gender of all subjects was measured. The blood pressure, body weight and body mass index (BMI) were measured routinely. Fasting venous blood was collected and fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), serum uric acid levels. The prevalence of NAFLD in healthy subjects was calculated. The prevalence of NAFLD in different sexes and healthy subjects was analyzed. The BMI, blood pressure, FPG, serum lipids and serum uric acid of the two groups were compared and unconditional Logistic regression analysis was performed. Results 992 NAFLD cases were detected, the prevalence of NAFLD was 29.7%. With the increase of age, the prevalence of NAFLD in both men and women tended to increase. The prevalence of NAFLD in males before 50 years old was significantly higher than that in females (P <0.05). There was no significant difference in the prevalence of NAFLD among men and women aged 50-60 years (P> 0.05). The levels of BMI, SBP, DBP, FPG, TC, TG, LDL-C and serum uric acid were significantly higher in H-DLC group than those in control group (all P <0.05). Logistic regression analysis showed that gender, BMI , SBP, DBP, FPG, TC, TG, L-DLC, H-DLC and serum uric acid were the risk factors of NAFLD. Conclusions Male is a high risk population of NAFLD. It can reduce body weight and maintain normal blood pressure, blood glucose, blood lipid and serum uric acid levels, enhance public awareness of health care, regular physical examination and early screening, and actively prevent the occurrence of NAFLD, The prevalence.