Wang Zhongli, Xu Ming, Hu Zhengguo, Hultström Michael, Lai Enyin
aDepartment of Internal Medicine & Geriatrics, Zhongnan Hospital, Wuhan University School of Medicine, Wuhan bDepartment of Physiology, Zhejiang University School of Medicine, Hangzhou, China cIntegrative Physiology, Department of Medical Cell Biology dAnaesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Eur J Gastroenterol Hepatol. 2014 Sep;26(9):1015-21. doi: 10.1097/MEG.0000000000000151.
This study aimed to investigate the sex-specific prevalence and metabolic risk factors of fatty liver disease (FLD), and to predict the prevalence of steatohepatitis with liver fibrosis in Wuhan, south central China.
A cross-sectional study was conducted among 25,032 participants who underwent health checkups from 2010 to 2011 in Zhongnan hospital.
The prevalence of FLD was higher among men than among women (31.8 vs. 12.9%, P<0.0001). However, it increased markedly with age among women, and in the age-groups above 60 years, the prevalence was similar between men and women (26.4 vs. 27.6%, P>0.05). FLD was associated with obesity, increased levels of total cholesterol, triglycerides (TG), low-density lipoproteins, serum uric acid, aspartate aminotransferase, alanine aminotransferase, and fasting blood sugar, an aspartate aminotransferase/alanine aminotransferase ratio of less than 1, and a decreased level of high-density lipoprotein in both sexes. Multiple regression analyses showed that obesity, elevated levels of fasting blood sugar, TG, total cholesterol, and alanine aminotransferase, an aspartate aminotransferase/alanine aminotransferase ratio of less than 1, serum uric acid levels, and decreased high-density lipoprotein levels were related to FLD in men, whereas age played a more prominent role in women. The prevalence of steatohepatitis with advanced fibrosis, estimated using the BMI, age, ALT, and TG index (BAAT index), was 2.5% in men and 1.4% in women; more women with FLD had a BAAT score of 3 or higher compared with men (9.0 vs. 6.6%).
The prevalence of FLD in China is high among men and elderly women and is mainly related to various metabolic parameters. The prevalence of steatohepatitis with advanced fibrosis is considerably high among individuals with FLD.
本研究旨在调查中国中南部武汉市脂肪肝疾病(FLD)的性别特异性患病率及代谢危险因素,并预测合并肝纤维化的脂肪性肝炎的患病率。
对2010年至2011年在中南医院接受健康体检的25032名参与者进行了一项横断面研究。
男性FLD患病率高于女性(31.8%对12.9%,P<0.0001)。然而,女性患病率随年龄显著增加,在60岁以上年龄组中,男性和女性患病率相似(26.4%对27.6%,P>0.05)。FLD与肥胖、总胆固醇、甘油三酯(TG)、低密度脂蛋白、血清尿酸、天冬氨酸转氨酶、丙氨酸转氨酶水平升高、空腹血糖升高、天冬氨酸转氨酶/丙氨酸转氨酶比值小于1以及两性高密度脂蛋白水平降低有关。多元回归分析显示,肥胖、空腹血糖、TG、总胆固醇和丙氨酸转氨酶水平升高、天冬氨酸转氨酶/丙氨酸转氨酶比值小于1、血清尿酸水平以及高密度脂蛋白水平降低与男性FLD有关,而年龄在女性中起更突出的作用。使用BMI、年龄、ALT和TG指数(BAAT指数)估计的合并晚期纤维化的脂肪性肝炎患病率,男性为2.5%,女性为1.4%;与男性相比,更多FLD女性的BAAT评分为3或更高(9.0%对6.6%)。
中国男性和老年女性中FLD患病率较高,且主要与各种代谢参数有关。在FLD患者中,合并晚期纤维化的脂肪性肝炎患病率相当高。