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肥胖是与超声诊断的非酒精性脂肪性肝病相关的唯一独立因素:一项横断面病例对照研究。

Obesity is the only independent factor associated with ultrasound-diagnosed non-alcoholic fatty liver disease: a cross-sectional case-control study.

作者信息

Lee Sangyeoup, Jin Kim Yun, Yong Jeon Tae, Hoi Kim Hyoung, Woo Oh Sang, Park Yongsoon, Soo Kim Sung

机构信息

Family Medicine Division, Center for Obesity Nutrition and Metabolism, Pusan National University Hospital, Seo-gu, Busan, South Korea.

出版信息

Scand J Gastroenterol. 2006 May;41(5):566-72. doi: 10.1080/00365520500319591.

Abstract

OBJECTIVE

There is increasing interest in ultrasound-diagnosed non-alcoholic fatty liver disease (NAFLD) in the ambulatory care setting. The aim of this study was to determine the clinical and metabolic features of ultrasound-diagnosed NAFLD.

MATERIAL AND METHODS

Fifty ultrasound-diagnosed NAFLD patients who had not consumed alcohol for at least the previous 3 months were matched with 100 controls by age and gender distribution. Clinical, biochemical, and nutritional variables were compared between the ultrasound-diagnosed NAFLD patients and the controls. Conditional logistic regression analyses were used to identify independent factors associated with ultrasound-diagnosed NAFLD.

RESULTS

The ultrasound-diagnosed NAFLD patients had higher values on the anthropometric measurements than those of the controls. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), uric acid, and gamma-glutamyl transpeptidase levels were higher in the ultrasound-diagnosed NAFLD patients than those in the controls (p<0.001). The ASAT/ALAT ratio of the ultrasound-diagnosed NAFLD patients was lower than that of the controls (p<0.001). Total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, non-HDL-cholesterol, atherogenic index, fasting glucose, systolic blood pressure (BP), diastolic BP, and pulse pressure were higher in the ultrasound-diagnosed NAFLD patients than in the control subjects, while lipoprotein(a) was lower. There were no significant differences in low-density lipoprotein (LDL)-cholesterol levels or nutritional intake between patients and controls. Abnormal ASAT or ALAT, hypertriglyceridemia, lower HDL-cholesterol levels, silent myocardial ischemic pattern on electrocardiogram (ECG), impaired fasting glucose, and obesity were common among the ultrasound-diagnosed NAFLD patients. The only independent factor associated with ultrasound-diagnosed NAFLD was obesity (p<0.001).

CONCLUSIONS

Our data suggest that NAFLD diagnosed by ultrasound is associated with hypertriglyceridemia, impaired fasting glucose, silent myocardial ischemic pattern of ECG, obesity, and abnormal liver tests in adults. Among these factors, obesity was the only independent factor associated with ultrasound-diagnosed NAFLD.

摘要

目的

在门诊医疗环境中,超声诊断的非酒精性脂肪性肝病(NAFLD)越来越受到关注。本研究的目的是确定超声诊断的NAFLD的临床和代谢特征。

材料与方法

选取50例超声诊断为NAFLD且在至少过去3个月内未饮酒的患者,按照年龄和性别分布与100例对照进行匹配。比较超声诊断的NAFLD患者与对照组之间的临床、生化和营养变量。采用条件逻辑回归分析来确定与超声诊断的NAFLD相关的独立因素。

结果

超声诊断的NAFLD患者的人体测量值高于对照组。超声诊断的NAFLD患者的天冬氨酸转氨酶(ASAT)、丙氨酸转氨酶(ALAT)、尿酸和γ-谷氨酰转肽酶水平高于对照组(p<0.001)。超声诊断的NAFLD患者的ASAT/ALAT比值低于对照组(p<0.001)。超声诊断的NAFLD患者的总胆固醇、甘油三酯、高密度脂蛋白(HDL)-胆固醇、非HDL-胆固醇、动脉粥样硬化指数、空腹血糖、收缩压(BP)、舒张压和脉压高于对照组,而脂蛋白(a)则较低。患者与对照组之间的低密度脂蛋白(LDL)-胆固醇水平或营养摄入量无显著差异。超声诊断的NAFLD患者中,ASAT或ALAT异常、高甘油三酯血症、HDL-胆固醇水平降低、心电图(ECG)上的无症状心肌缺血模式、空腹血糖受损和肥胖较为常见。与超声诊断的NAFLD相关的唯一独立因素是肥胖(p<0.001)。

结论

我们的数据表明,超声诊断的NAFLD与成人的高甘油三酯血症、空腹血糖受损、ECG的无症状心肌缺血模式、肥胖和肝功能检查异常有关。在这些因素中,肥胖是与超声诊断的NAFLD相关的唯一独立因素。

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