Wang Zhongli, Xu Ming, Hu Zhengguo, Shrestha Umid Kumar
From the 1Department of Internal Medicine and Geriatrics, Zhongnan Hospital, Wuhan University School of Medicine, Wuhan, China; and 2Manipal College of Medical Sciences, Kaski Sewa Hospital and Research Center, Pokhara, Nepal.
Menopause. 2015 Jun;22(6):667-73. doi: 10.1097/GME.0000000000000352.
This study aims to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD), to determine the metabolic risk factors of this disease, and to predict nonalcoholic steatohepatitis (NASH) with liver fibrosis in women of different ages and body mass index (BMI).
In 2010-2011, a cross-sectional survey was conducted among 9,360 women at the health checkup center of Zhongnan Hospital (Wuhan, China). The probability of NASH with liver fibrosis was predicted using BAAT (BMI, age, alanine aminotransferase, and triglycerides) score.
The prevalence of NAFLD increased from 5.3% to 18.8% in women younger than 45 years versus women aged 45 to 55 years and rose to 27.8% in women older than 55 years. In obese women, the prevalence of NAFLD was 48.4%. Women older than 45 years and obese women with NAFLD had more unfavorable metabolic risk factors. Multiple regression analyses showed that increased BMI and low aspartate aminotransferase-to-alanine aminotransferase ratio were closely related to NAFLD in women of different ages, whereas increasing BMI, BAAT score, age, high triglycerides, alanine aminotransferase, and low aspartate aminotransferase-to-alanine aminotransferase ratio were all closely related to NAFLD in obese women. The prevalence of NASH with a BAAT index of 3 or higher was 13.2% and 14.9% in women older than 55 years and obese women with NAFLD, respectively.
Obese and postmenopausal women have a high prevalence of NAFLD and severe metabolic disorders. The prevalence of NASH seems to be considerably higher in obese and postmenopausal women with NAFLD.
本研究旨在调查非酒精性脂肪性肝病(NAFLD)的患病率,确定该疾病的代谢危险因素,并预测不同年龄和体重指数(BMI)的女性非酒精性脂肪性肝炎(NASH)合并肝纤维化的情况。
2010年至2011年,在中南医院(中国武汉)健康体检中心对9360名女性进行了横断面调查。使用BAAT(BMI、年龄、丙氨酸氨基转移酶和甘油三酯)评分预测NASH合并肝纤维化的可能性。
45岁以下女性的NAFLD患病率从5.3%升至45至55岁女性的18.8%,55岁以上女性则升至27.8%。肥胖女性中,NAFLD患病率为48.4%。45岁以上女性和患有NAFLD的肥胖女性有更多不良代谢危险因素。多元回归分析显示,BMI升高和天冬氨酸氨基转移酶与丙氨酸氨基转移酶比值降低在不同年龄女性中均与NAFLD密切相关,而在肥胖女性中,BMI升高、BAAT评分、年龄、高甘油三酯、丙氨酸氨基转移酶和天冬氨酸氨基转移酶与丙氨酸氨基转移酶比值降低均与NAFLD密切相关。BAAT指数为3或更高的NASH患病率在55岁以上女性和患有NAFLD的肥胖女性中分别为13.2%和14.9%。
肥胖和绝经后女性NAFLD患病率高,且存在严重代谢紊乱。在患有NAFLD的肥胖和绝经后女性中,NASH患病率似乎相当高。