Department of Gastroenterology, The First Affiliated Hospital, Medicine School, Zhejiang University, Hangzhou, China.
Eur J Gastroenterol Hepatol. 2010 Jul;22(7):820-5. doi: 10.1097/MEG.0b013e3283328b86.
To conduct a cohort study of the effect of alcohol and obesity on liver enzymes in China.
To study 500 individuals of liver enzymes normality randomly in the 1999-year epidemiological survey, and liver enzyme levels (461 complete data) in 2006.
Logistic-regression analysis showed a daily alcohol intake of at least 40 g, duration of drinking at least 10 years, and obesity, which were closely related to abnormality in liver enzyme levels; the relative risk (95% confidence interval) was 2.014 (1.108-3.662), 2.085 (1.106-3.928), and 1.772 (1.140-2.754), respectively (all P<0.05). According to the value of daily alcohol intake/duration of drinking and body mass index (BMI) to categorize, seven-year cumulative incidence of liver enzymes levels abnormality for the daily alcohol intake at least 40 g and obesity group or the duration of drinking at least 10 years and obesity group was the highest, 51.47 and 47.12%, respectively. No significant dose-response relationship was found between daily alcohol intake/duration of drinking and liver enzyme level abnormalities.
The risk of alcohol consumption and obesity-inducing liver injury together is far greater than the risk of a single factor inducing liver injury. An alcoholic threshold effect may be more important than a dose-response effect on liver enzyme levels.
在中国进行一项关于酒精和肥胖对肝酶影响的队列研究。
在 1999 年的流行病学调查中,随机抽取了 500 名肝酶正常的个体,并对其 2006 年的肝酶水平(461 个完整数据)进行了研究。
logistic 回归分析显示,每日饮酒至少 40g,饮酒至少 10 年,以及肥胖与肝酶水平异常密切相关;相对风险(95%置信区间)分别为 2.014(1.108-3.662)、2.085(1.106-3.928)和 1.772(1.140-2.754)(均 P<0.05)。根据每日饮酒量/饮酒时间和体重指数(BMI)的值进行分类,每日饮酒量至少 40g 且肥胖组或饮酒时间至少 10 年且肥胖组的肝酶水平异常的 7 年累积发生率最高,分别为 51.47%和 47.12%。每日饮酒量/饮酒时间与肝酶水平异常之间未发现明显的剂量-反应关系。
饮酒和肥胖导致肝损伤的风险之和远远大于单一因素导致肝损伤的风险。酒精对肝酶水平的阈效应可能比剂量-反应效应更为重要。