Zhang Tao, Zhang Yongyuan, Zhang Chengqi, Tang Fang, Li Hongkai, Zhang Qian, Lin Haiyan, Wu Shuo, Liu Yanxun, Xue Fuzhong
Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, China.
Medical Department,Qilu Hospital of Shandong University, Jinan, China.
PLoS One. 2014 May 6;9(5):e96651. doi: 10.1371/journal.pone.0096651. eCollection 2014.
To explore the relationship between non-alcoholic fatty liver disease (NAFLD) and the metabolic syndrome (MetS), and evaluate the value of NAFLD as a marker for predicting the risk of MetS in a large scale prospective cohort from northern urban Han Chinese population.
A total of 17,920 MetS-free at baseline cohort members was included in the current study between 2005 and 2011. The baseline characteristics of the cohort were compared by NAFLD status at baseline, MetS status after follow-up. Cox proportional hazards models were used to estimate the unadjusted or adjusted hazard ratios (HRs) for NAFLD at baseline predicting the risk of MetS.
2,183 (12.18%) new cases of MetS occurred between 2005 and 2011. In unadjusted model, HRs (95% CIs) for NAFLD predicting MetS was 3.65 (3.35, 3.97). After adjusting the confounding factors of age, gender, the metabolic factors, smoke and exercise, the HRs (95% CIs) was 1.70 (1.55, 1.87). Gender difference was observed, adjusted HRs (95% CIs) of NAFLD for predicting MetS were 2.06(1.72, 2.46) and 1.55(1.39, 1.72) in female and male population, respectively. Moreover, 163 participants developed MetS among participants without any MetS component at baseline, and its adjusted HRs was still significant, 1.87 (1.12, 3.13).
The present study indicates that NAFLD is an independent risk factor for predicting the risk of MetS in northern urban Han Chinese population, and the people with NAFLD should initiate weight and dietary control to prevent the occurrence of MetS.
探讨非酒精性脂肪性肝病(NAFLD)与代谢综合征(MetS)之间的关系,并评估在北方城市汉族大规模前瞻性队列中,NAFLD作为预测MetS风险标志物的价值。
2005年至2011年期间,本研究共纳入17920名基线时无MetS的队列成员。根据基线时的NAFLD状态、随访后的MetS状态比较队列的基线特征。采用Cox比例风险模型估计基线时NAFLD预测MetS风险的未调整或调整风险比(HRs)。
2005年至2011年期间,共出现2183例(12.18%)新的MetS病例。在未调整模型中,NAFLD预测MetS的HRs(95%CI)为3.65(3.35,3.97)。在调整年龄、性别、代谢因素、吸烟和运动等混杂因素后,HRs(95%CI)为1.70(1.55,1.87)。观察到性别差异,女性和男性人群中NAFLD预测MetS的调整HRs(95%CI)分别为2.06(1.72,2.46)和1.55(1.39,1.72)。此外,163名参与者在基线时无任何MetS组分,随访期间发生了MetS,其调整后的HRs仍具有统计学意义,为1.87(1.12,3.13)。
本研究表明,NAFLD是北方城市汉族人群预测MetS风险的独立危险因素,NAFLD患者应开始控制体重和饮食,以预防MetS的发生。