Bedogni Giorgio, Miglioli Lucia, Masutti Flora, Tiribelli Claudio, Marchesini Giulio, Bellentani Stefano
Centro Studi Fegato, AREA Science Park, Basovizza, and Department of BBCM, University of Trieste, Italy.
Hepatology. 2005 Jul;42(1):44-52. doi: 10.1002/hep.20734.
The prevalence of and the risk factors for fatty liver have not undergone a formal evaluation in a representative sample of the general population. We therefore performed a cross-sectional study in the town of Campogalliano (Modena, Italy), within the context of the Dionysos Project. Of 5,780 eligible persons aged 18 to 75 years, 3,345 (58%) agreed to participate in the study. Subjects with suspected liver disease (SLD), defined on the basis of elevated serum alanine aminotransferase (ALT) and gamma-glutamyl-transferase (GGT) activity, hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV)-RNA positivity, were matched with randomly selected subjects of the same age and sex without SLD. A total of 311 subjects with and 287 without SLD underwent a detailed clinical, laboratory, and anthropometrical evaluation. Fatty liver was diagnosed by ultrasonography, and alcohol intake was assessed by using a 7-day diary. Multinomial logistic regression was used to detect risk factors for normal liver versus nonalcoholic fatty liver disease (NAFLD) and for alcoholic fatty liver (AFLD) versus NAFLD. The prevalence of NAFLD was similar in subjects with and without SLD (25 vs. 20%, P = .203). At multivariable analysis, normal liver was more likely than NAFLD in older subjects and less likely in the presence of obesity, hyperglycemia, hyperinsulinemia, hypertriglyceridemia, and systolic hypertension; AFLD was more likely than NAFLD in older subjects, males, and in the presence of elevated GGT and hypertriglyceridemia, and less likely in the presence of obesity and hyperglycemia. In conclusion, NAFLD is highly prevalent in the general population, is not associated with SLD, but is associated with many features of the metabolic syndrome.
在普通人群的代表性样本中，尚未对脂肪肝的患病率及其危险因素进行正式评估。因此，我们在意大利摩德纳市坎波加利亚诺镇开展了一项横断面研究，该研究是酒神计划的一部分。在5780名年龄在18至75岁的符合条件者中，3345人（58%）同意参与研究。根据血清丙氨酸氨基转移酶（ALT）和γ-谷氨酰转移酶（GGT）活性升高、乙肝表面抗原（HBsAg）或丙型肝炎病毒（HCV）-RNA阳性定义的疑似肝病（SLD）患者，与随机选择的同年龄、同性别的无SLD患者进行匹配。共有311名有SLD的患者和287名无SLD的患者接受了详细的临床、实验室和人体测量学评估。通过超声诊断脂肪肝，通过7天日记评估酒精摄入量。采用多项逻辑回归分析来检测正常肝脏与非酒精性脂肪性肝病（NAFLD）以及酒精性脂肪性肝病（AFLD）与NAFLD的危险因素。有SLD和无SLD的患者中NAFLD的患病率相似（分别为25%和20%，P = 0.203）。在多变量分析中，老年受试者中正常肝脏比NAFLD更常见，而在存在肥胖、高血糖、高胰岛素血症、高甘油三酯血症和收缩期高血压的情况下则较少见；老年受试者、男性以及存在GGT升高和高甘油三酯血症时，AFLD比NAFLD更常见，而在存在肥胖和高血糖时则较少见。总之，NAFLD在普通人群中非常普遍，与SLD无关，但与代谢综合征的许多特征相关。
