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非酒精性脂肪性肝病与中国人自主神经功能紊乱的相关性。

Association between non-alcoholic fatty liver disease and autonomic dysfunction in a Chinese population.

机构信息

From the Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Ruijin Hospital, E-Institute of Shanghai Universities, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, and

From the Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Ruijin Hospital, E-Institute of Shanghai Universities, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, and.

出版信息

QJM. 2015 Aug;108(8):617-24. doi: 10.1093/qjmed/hcv006. Epub 2015 Jan 21.

Abstract

BACKGROUND

Autonomic dysfunction (AD) accompanying with chronic liver disorders led to an increased risk of mortality. However, researches that investigated the association between non-alcoholic fatty liver disease (NAFLD) and AD were insufficient.

AIMS

To study the association of NAFLD with AD in middle-aged and elderly Chinese adults.

DESIGN

Four thousand nine hundred seventy-four adults aged 40 years or older were enrolled in this cross-sectional study. NAFLD was diagnosed by hepatic B-mode ultrasonography. Autonomic function was assessed using a simple EZSCAN test by measuring sudomotor function, with an AD index > 50% defined as a manifestation of AD.

METHODS

Pearson correlation, multiple stepwise linear regression, univariate and multivariate logistic regression was employed to examine the relationship between NAFLD and AD, controlling for potential confounders.

RESULTS

The prevalence of AD was significantly higher in participants with NAFLD than those without (40.75 vs. 26.86%, P < 0.0001). Age, body mass index, status of diabetes, sex, diastolic blood pressure and prevalent NAFLD, were positively correlated with AD index in multiple stepwise linear regression analysis (all P < 0.05), whereas total cholesterol was negatively related to it (P = 0.0043). Compared with the participants without NAFLD, those with NAFLD had an increased odds of the prevalent AD (odds ratio 1.38; 95% confidence interval 1.15-1.64; P = 0.0004) after controlling for multiple confounders.

CONCLUSIONS

The presence of NAFLD was significantly associated with AD, as indicated by abnormal sudomotor function. The association was independent from various conventional risk factors.

摘要

背景

慢性肝脏疾病伴自主神经功能障碍(AD)会增加死亡风险。然而,关于非酒精性脂肪性肝病(NAFLD)与 AD 之间关系的研究还不够充分。

目的

研究中年和老年中国成年人中 NAFLD 与 AD 的相关性。

设计

本横断面研究纳入了 4974 名年龄在 40 岁或以上的成年人。NAFLD 通过肝脏 B 型超声诊断。自主神经功能通过简单的 EZSCAN 测试进行评估,通过测量出汗功能,AD 指数>50%定义为 AD 的表现。

方法

采用 Pearson 相关、多元逐步线性回归、单因素和多因素 logistic 回归分析来检查 NAFLD 与 AD 之间的关系,控制潜在的混杂因素。

结果

NAFLD 患者 AD 的患病率明显高于无 NAFLD 患者(40.75%比 26.86%,P<0.0001)。多元逐步线性回归分析显示,年龄、体重指数、糖尿病状态、性别、舒张压和现患 NAFLD 与 AD 指数呈正相关(均 P<0.05),而总胆固醇与之呈负相关(P=0.0043)。在校正多种混杂因素后,与无 NAFLD 的参与者相比,有 NAFLD 的参与者发生 AD 的几率更高(比值比 1.38;95%置信区间 1.15-1.64;P=0.0004)。

结论

异常出汗功能表明,NAFLD 与 AD 显著相关,且这种相关性独立于各种传统危险因素。

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