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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-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:3.65～76.62)、体重明显增加(OR=16.75,95%CI:3.11～90.15)、三酰甘油(OR=4.91,95%CI:1.89～12.75))、出行方式(OR=0.09,95%CI:0.023～0.369)以及偶尔食用坚果(OR=0.127,95%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。
Objective To investigate the risk factors of non-alcoholic fatty liver disease (NAFLD) in Tianjin health examination population. Methods A case-control study was conducted to analyze the physical examination results and life style of 100 non-alcoholic fatty liver patients who meet the diagnostic criteria and 100 normal controls with the exception of NAFLD. Single-factor and multivariate non-conditional logistic regression Regression analysis for statistical processing. Results Univariate analysis showed that the occurrence of NAFLD correlated with body mass index (BMI), waist circumference, WHR, FBG, TG, HDL-C, Low density lipoprotein cholesterol (VLDL-C), alanine aminotransferase (ALT), umbilical plexus, triceps and scapular skinfold thickness, restaurant eating frequency, supper frequency, travel style, physical activity, weight change, Hypertension and diabetes history. Multivariate Logistic regression analysis showed that the thickness of umbilical fold (OR = 6.68, 95% CI: 2.38-18.77) and hypertension (hypertension) were significantly higher than those without exercise-related BMI and umbilical skinfold OR = 16.75, 95% CI: 3.11-90.15), triglyceride (OR = 4.91, 95% CI: 1.89-12.75), mode of travel (OR = 0.09, 95% CI: 0.023-0.369) and occasional nut consumption (OR = 0.127, 95% CI: 0.02-0.79) were independently associated with NAFLD. Conclusions The umbilical skinfold thickness, hypertension, triglyceride and body weight are the independent risk factors of NAFLD. The walking or cycling mode of travel and the occasional nutation are the independent protective factors of NAFLD.