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[健康体检者中心血管危险因素与非酒精性脂肪性肝病的关联]

[The association of cardiovascular risk factors with nonalcoholic fatty liver disease in health checkup examinees].

作者信息

Yu Jae-Hee, Lee Kang-Sook, Lee Seon-Young, Hong A-Rum, Park Yong-Sang

机构信息

Graduate School of Public Health, The Catholic University of Korea.

出版信息

J Prev Med Public Health. 2008 Nov;41(6):407-12. doi: 10.3961/jpmph.2008.41.6.407.

Abstract

OBJECTIVES

The purpose of this study was to evaluate the relationship of nonalcoholic fatty liver and cardiovascular risk factors.

METHODS

This study was conducted to investigate the association of nonalcoholic fatty liver and cardiovascular risk factors for adult men (n=2976) and women (n=2442) who were over 19 years old, after excluding the HBsAg(+) or anti-HCV(+) patients and the men and women with increased alcohol intake (men: 40 g/week, women: 20 g/week).

RESULTS

Compared with the normal liver subjects, the nonalcoholic fatty liver subjects showed a significantly increased frequency of abnormal systolic blood pressure (> or =120 mmHg), fasting blood sugar (> or =100 mg/dL), total cholesterol (> or =200 mg/dL), triglyceride (> or =150 mg/dL), high density lipoprotein cholesterol (<40 mg/dL), low density lipoprotein cholesterol (> or =130 g m/dL) and abdominal obesity in men, and all these measures were significantly increased in the women except for abnormal HDL cholesterol. After adjusting for the body mass index, age, smoking, exercise and a nonalcoholic liver, the odds ratios of an abnormal waist hip ratio were 1.35(95% Confidence Interval=1.05-4.72) in the mild fatty liver, 1.61(1.19-2.18) in the moderate fatty liver, 2.77(1.57-4.92) in the severe fatty liver compared with a normal liver. The adjusted odds ratios for abnormal fasting blood sugar were 1.26(1.03-1.53) in the mild fatty liver, 1.62(1.27-2.06) in the moderate fatty liver and 1.77(1.12-2.78) in the severe fatty liver. The adjusted odds ratios for abnormal triglyceride were 1.38(1.11-1.72) in the mild fatty liver, 1.73(0.33-2.24) in the moderate fatty liver and 1.91(1.17-3.10) in the severe fatty liver of men. Adjusted odds ratios for abnormal triglyceride were 1.50(1.04-2.15) in mild, 1.71(1.07-2.68) in moderate, 1.81(0.69-4.38) in severe fatty liver of women.

CONCLUSIONS

The nonalcoholic fatty liver subjects had more cardiovascular risk factors compared with the normal liver subjects. Thus, prevention and treatment of the nonalcoholic fatty liver is necessary by lifestyle modifications such as restriction of alcohol intake, no smoking, exercise and adequate eating habits.

摘要

目的

本研究旨在评估非酒精性脂肪肝与心血管危险因素之间的关系。

方法

本研究针对19岁以上的成年男性(n = 2976)和女性(n = 2442),在排除乙肝表面抗原(HBsAg)阳性或丙肝抗体(anti-HCV)阳性患者以及酒精摄入量增加的男性(每周40克)和女性(每周20克)后,调查非酒精性脂肪肝与心血管危险因素之间的关联。

结果

与正常肝脏受试者相比,非酒精性脂肪肝受试者的收缩压异常(≥120 mmHg)、空腹血糖(≥100 mg/dL)、总胆固醇(≥200 mg/dL)、甘油三酯(≥150 mg/dL)、高密度脂蛋白胆固醇(<40 mg/dL)、低密度脂蛋白胆固醇(≥130 mg/dL)以及男性腹部肥胖的发生率显著增加,而女性除高密度脂蛋白胆固醇异常外,所有这些指标均显著增加。在调整体重指数、年龄、吸烟、运动和非酒精性肝病后,轻度脂肪肝患者腰臀比异常的优势比为1.35(95%置信区间=1.05 - 4.72),中度脂肪肝患者为1.61(1.19 - 2.18),重度脂肪肝患者为2.77(1.57 - 4.92),与正常肝脏相比。轻度脂肪肝患者空腹血糖异常的调整后优势比为1.26(1.03 - 1.53),中度脂肪肝患者为1.62(1.27 - 2.06),重度脂肪肝患者为1.77(1.12 - 2.78)。男性轻度脂肪肝患者甘油三酯异常的调整后优势比为1.38(1.11 - 1.72),中度脂肪肝患者为1.73(0.33 - 2.24),重度脂肪肝患者为1.91(1.17 - 3.10)。女性轻度脂肪肝患者甘油三酯异常的调整后优势比为1.50(1.04 - 2.15),中度脂肪肝患者为1.71(1.07 - 2.68),重度脂肪肝患者为1.81(0.69 - 4.38)。

结论

与正常肝脏受试者相比,非酒精性脂肪肝受试者具有更多的心血管危险因素。因此,通过限制酒精摄入、戒烟、运动和养成良好饮食习惯等生活方式的改变来预防和治疗非酒精性脂肪肝是必要的。

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