Department of Digestive and Life-Style Related Diseases, Health Research Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
J Gastroenterol. 2011 Jun;46(6):769-78. doi: 10.1007/s00535-011-0376-z. Epub 2011 Feb 8.
Metabolic syndrome, which includes obesity, hyperglycemia, dyslipidemia, and hypertension, is a major risk factor for the development of nonalcoholic fatty liver disease (NAFLD). Cigarette smoking is a well-known risk factor for metabolic syndrome, but the epidemiological impact of cigarette smoking on development of NAFLD is unclear.
In this retrospective study, 2,029 subjects underwent a complete medical health checkup in 1998 and again in 2008. Those who were positive for hepatitis B surface antigen or hepatitis C virus antibody, or had an alcohol intake of > 20 g/day as assessed by questionnaire, were excluded. Fatty liver was diagnosed by abdominal ultrasonography. Independent risk factors associated with the development of NAFLD were determined by multiple logistic regression analysis. Smoking status was expressed using the Brinkman index (BI), which was calculated as the number of cigarettes smoked per day multiplied by the number of years of smoking.
Of 1,560 subjects without NAFLD in 1998, 266 (17.1%) were newly diagnosed with NAFLD in 2008. Multiple logistic analysis identified age [adjusted odds ratio (AOR) 0.95, 95% confidence interval (95% CI) 0.94-0.97], male sex (AOR 1.46, 95% CI 1.01-2.10), body mass index ≥ 25 (AOR 3.08, 95% CI 2.20-4.32), dyslipidemia (AOR 1.79, 95% CI 1.25-2.58) and cigarette smoking (AOR 1.91, 95% CI 1.34-2.72) as risk factors associated with the development of NAFLD. Smoking status at baseline was also associated with the development of NAFLD (BI 1-399: AOR 1.77, 95% CI 1.02-3.07, BI ≥ 400: AOR 2.04, 95% CI 1.37-3.03).
Cigarette smoking is an independent risk factor for onset of NAFLD.
代谢综合征包括肥胖、高血糖、血脂异常和高血压，是导致非酒精性脂肪性肝病（NAFLD）的主要危险因素。吸烟是代谢综合征的一个已知危险因素，但吸烟对 NAFLD 发展的流行病学影响尚不清楚。
在这项回顾性研究中，2029 名受试者于 1998 年和 2008 年接受了全面的健康体检。排除乙型肝炎表面抗原阳性或丙型肝炎病毒抗体阳性，或通过问卷调查发现每日酒精摄入量>20g 的患者。通过腹部超声诊断脂肪肝。采用多因素 logistic 回归分析确定与 NAFLD 发生相关的独立危险因素。吸烟状况用香烟支数乘以吸烟年数的布立克曼指数（BI）表示。
在 1998 年无 NAFLD 的 1560 名受试者中，2008 年有 266 名（17.1%）新诊断为 NAFLD。多因素 logistic 分析发现年龄[调整优势比（AOR）0.95，95%置信区间（95%CI）0.94-0.97]、男性（AOR 1.46，95%CI 1.01-2.10）、体重指数≥25（AOR 3.08，95%CI 2.20-4.32）、血脂异常（AOR 1.79，95%CI 1.25-2.58）和吸烟（AOR 1.91，95%CI 1.34-2.72）是与 NAFLD 发生相关的危险因素。基线时的吸烟状况也与 NAFLD 的发生相关（BI 1-399：AOR 1.77，95%CI 1.02-3.07，BI≥400：AOR 2.04，95%CI 1.37-3.03）。
吸烟是 NAFLD 发病的独立危险因素。
