Omagari Katsuhisa, Kadokawa Yoshiko, Masuda Jun-Ichi, Egawa Ichiei, Sawa Takafumi, Hazama Hiroaki, Ohba Kazuo, Isomoto Hajime, Mizuta Yohei, Hayashida Kenji, Murase Kunihiko, Kadota Takehiko, Murata Ikuo, Kohno Shigeru
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
J Gastroenterol Hepatol. 2002 Oct;17(10):1098-105. doi: 10.1046/j.1440-1746.2002.02846.x.
Fatty liver is not uncommon in many countries, including Japan, and is mainly caused by alcohol usage and obesity. The aim of this study was to determine the incidence and causative factors of fatty liver in Japanese adults.
The clinical characteristics of 3432 Japanese adults who visited our hospital between January and December 2000 for thorough medical examinations were recorded including sex, age, body mass index (BMI), percentage body fat measurement using a bipedal bioimpedance instrument, history of alcohol intake, blood pressure, serum levels of aspartate aminotransferase, alanine aminotransferase (ALT), gamma-glutamyl transpeptidase, total cholesterol, triglyceride, uric acid, fasting blood glucose (FBG), and liver status by ultrasonography (USG).
Of 3432 participants, 747 (21.8%) were diagnosed as having fatty liver by USG, 1873 (54.6%) were 'daily alcohol drinkers', and 698 (20.3%) were overweight (BMI >or= 25 kg/m2). Fatty liver was more frequent in men and overweight subjects (P < 0.01), whereas there was no significant difference in the proportion of the 'daily alcohol drinker' between fatty liver and non-fatty liver participants. The logistic regression analysis showed that BMI, ALT, and triglyceride were independent predictors of fatty liver in both sexes, and FBG, uric acid, percentage body fat, and total cholesterol were independent predictors of fatty liver only in men. It was noted that 319 (9.3%) were non-alcoholic individuals with fatty liver, and 141 (4.1%) were non-alcoholic and non-overweight individuals with fatty liver. The logistic regression analysis showed that percentage body fat was an independent predictor of fatty liver in non-alcoholic and non-overweight participants in both sexes, although non-significant in women in the whole group.
In our study population, 21.8% had fatty liver diagnosed by USG, 9.3% were non-alcoholic with fatty liver, and 4.1% were non-alcoholic and non-overweight with fatty liver. Our results suggest that central body fat distribution can correlate with the development of fatty liver, and that measurement of percentage body fat is useful to assess the etiology of fatty liver in non-alcoholic and non-overweight participants, particularly women.
脂肪肝在包括日本在内的许多国家并不罕见，主要由饮酒和肥胖引起。本研究的目的是确定日本成年人脂肪肝的发病率及致病因素。
记录了2000年1月至12月期间到我院进行全面体检的3432名日本成年人的临床特征，包括性别、年龄、体重指数（BMI）、使用双足生物阻抗仪测量的体脂百分比、饮酒史、血压、血清天冬氨酸氨基转移酶、丙氨酸氨基转移酶（ALT）、γ-谷氨酰转肽酶、总胆固醇、甘油三酯、尿酸、空腹血糖（FBG）以及通过超声检查（USG）得出的肝脏状况。
在3432名参与者中，747人（21.8%）经超声检查诊断为脂肪肝，1873人（54.6%）为“每日饮酒者”，698人（20.3%）超重（BMI≥25kg/m²）。脂肪肝在男性和超重者中更为常见（P<0.01），而“每日饮酒者”在脂肪肝参与者和非脂肪肝参与者中的比例无显著差异。逻辑回归分析表明，BMI、ALT和甘油三酯是男女脂肪肝的独立预测因素，而FBG、尿酸、体脂百分比和总胆固醇仅在男性中是脂肪肝的独立预测因素。值得注意的是，319人（9.3%）为非酒精性脂肪肝患者，141人（4.1%）为非酒精性且非超重的脂肪肝患者。逻辑回归分析表明，体脂百分比是男女非酒精性且非超重参与者脂肪肝的独立预测因素，尽管在整个女性群体中不显著。
在我们的研究人群中，21.8%经超声检查诊断为脂肪肝，9.3%为非酒精性脂肪肝患者，4.1%为非酒精性且非超重的脂肪肝患者。我们的结果表明，中心性体脂分布可能与脂肪肝的发生相关，并且测量体脂百分比有助于评估非酒精性且非超重参与者，尤其是女性脂肪肝的病因。
