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[非酒精性脂肪性肝病相关危险因素:一项病例对照研究]

[Risk factors associated with non-alcoholic fatty liver disease: a case-control study].

作者信息

Caballería Llorenç, Arteaga Ingrid, Pera Guillem, Rodríguez Lluís, Alumà Alba, Auladell Maria Antònia, Torán Pere

机构信息

Centre d'Atenció Primària Premià de Mar, Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Premià de Mar, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Mataró, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, España.

出版信息

Med Clin (Barc). 2013 Sep 21;141(6):233-9. doi: 10.1016/j.medcli.2012.11.034. Epub 2013 Apr 17.

Abstract

BACKGROUND AND OBJECTIVES

To establish the factors associated with the presence of non-alcoholic fatty liver disease (NAFLD) and evaluate the influence of each component constituting the metabolic syndrome (MS) and the risk of developing NAFLD.

PATIENTS AND METHODS

We performed a multicenter, population-based, observational, analytical study of cases and controls. A case was defined as any patient fulfilling the inclusion criteria and presenting NAFLD by abdominal echography for any reason. A control was randomly selected for each case, from the same health center and of the same age and sex. All the cases underwent anamnesis, physical examination, complete biochemical analyses and determination of MS according to the National Cholesterol Education Program-Adult Treatment Panel III criteria. All the controls also underwent an abdominal echography.

RESULTS

We included 327 cases and 377 controls with a mean age of 56 ± 12 years for the cases and of 55 ± 13 years for the controls (range: 17 and 80 years); 52.0% of the cases were males and 49.1% of males were controls. The risk factors associated with NAFLD were obesity (odds ratio [OR] 3.82, 95% confidence interval [95% CI] 2.19-6.66), MS (OR 1.73, 95% CI 1.09-2.75), insulin resistance (OR 3.65, 95% CI 2.18-6.12), and an increase in alanine aminotransferase (ALT) (OR 4.72, 95% CI 2.58-8.61) and gamma glutamyl transferase values (GGT) (OR 1.95, 95% CI 1.14-3.34). The components of the MS best predicting NAFLD were hyperglycemia (OR 1.65, 95% CI1.06-2.56) and triglyceride values (OR 1.75, 95% CI1.13-2.72).

CONCLUSIONS

The independent variables associated with NAFLD were obesity, insulin resistance and elevated ALT and GGT. The components of MS best predicting NAFLD were hyperglycemia and an increase in triglyceride values.

摘要

背景与目的

确定与非酒精性脂肪性肝病(NAFLD)存在相关的因素,并评估构成代谢综合征(MS)的各组分的影响以及发生NAFLD的风险。

患者与方法

我们开展了一项多中心、基于人群的病例对照观察性分析研究。病例定义为符合纳入标准且因任何原因经腹部超声检查确诊为NAFLD的任何患者。为每个病例从同一健康中心随机选取年龄和性别相同的对照。所有病例均接受问诊、体格检查、全面生化分析,并根据美国国家胆固醇教育计划成人治疗专家组第三次报告标准确定是否患有MS。所有对照也接受腹部超声检查。

结果

我们纳入了327例病例和377例对照,病例的平均年龄为56±12岁,对照的平均年龄为55±13岁(范围:17至80岁);52.0%的病例为男性,49.1%的男性为对照。与NAFLD相关的危险因素为肥胖(比值比[OR]3.82,95%置信区间[95%CI]2.19 - 6.66)、MS(OR 1.73,95%CI 1.09 - 2.75)、胰岛素抵抗(OR 3.65,95%CI 2.18 - 6.12),以及丙氨酸氨基转移酶(ALT)升高(OR 4.72,95%CI 2.58 - 8.61)和γ-谷氨酰转移酶值(GGT)升高(OR 1.95,95%CI 1.14 - 3.34)。最能预测NAFLD的MS组分是高血糖(OR 1.65,95%CI 1.06 - 2.56)和甘油三酯值(OR 1.75,95%CI 1.13 - 2.72)。

结论

与NAFLD相关的独立变量为肥胖、胰岛素抵抗以及ALT和GGT升高。最能预测NAFLD的MS组分是高血糖和甘油三酯值升高。

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