幽门螺杆菌感染与包括非酒精性脂肪性肝病在内的脂肪性肝病无关：日本的一项大规模横断面研究。
Helicobacter pylori infection is not associated with fatty liver disease including non-alcoholic fatty liver disease: a large-scale cross-sectional study in Japan.
作者信息
Okushin Kazuya, Takahashi Yu, Yamamichi Nobutake, Shimamoto Takeshi, Enooku Kenichiro, Fujinaga Hidetaka, Tsutsumi Takeya, Shintani Yoshizumi, Sakaguchi Yoshiki, Ono Satoshi, Kodashima Shinya, Fujishiro Mitsuhiro, Moriya Kyoji, Yotsuyanagi Hiroshi, Mitsushima Toru, Koike Kazuhiko
机构信息
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kameda Medical Center Makuhari (CD-2, 1-3, Nakase, Mihama-ku, Chiba-city, Japan.
出版信息
BMC Gastroenterol. 2015 Feb 19;15:25. doi: 10.1186/s12876-015-0247-9.
BACKGROUND
Fatty liver disease (FLD) including non-alcoholic fatty liver disease (NAFLD), a rapidly emerging and widely recognized liver disease today, is regarded as a hepatic manifestation of metabolic syndrome. Helicobacter pylori, one of the most common pathogens worldwide, has been reported to be associated with metabolic syndrome, but whether there is a direct association with FLD is as of yet unclear. The aim of this study was to clarify the association of FLD and NAFLD with causative background factors including Helicobacter pylori infection.
METHODS
This was a cross-sectional study of Japanese adults who received medical checkups at a single medical center in 2010.Univariate and multivariate statistical analysis was performed to evaluate background factors for ultrasonography diagnosed FLD. Subjects free from alcohol influence were similarly analyzed for NAFLD.
RESULTS
Of a total of 13,737 subjects, FLD was detected in 1,456 of 6,318 females (23.0 %) and 3,498 of 7,419 males (47.1%). Multivariable analyses revealed that body mass index (standardized coefficients of females and males (β-F/M) =143.5/102.5), serum ALT (β-F/M = 25.8/75.7), age (β-F/M = 34.3/17.2), and platelet count (β-F/M = 17.8/15.2) were positively associated with FLD in both genders. Of the 5,289 subjects free from alcohol influence, NAFLD was detected in 881 of 3,473 females (25.4%) and 921 of 1,816 males (50.7%). Body mass index (β-F/M = 113.3/55.3), serum ALT (β-F/M = 21.6/53.8), and platelet count (β-F/M = 13.8/11.8) were positively associated with NAFLD in both genders. Metabolic syndrome was positively associated with FLD and NAFLD only in males. In contrast, Helicobacter pylori infection status was neither associated with FLD nor NAFLD regardless of gender.
CONCLUSIONS
Body mass index, serum ALT and platelet count were significantly associated with FLD and NAFLD, whereas infection of Helicobacter pylori was not.
背景
脂肪性肝病（FLD），包括非酒精性脂肪性肝病（NAFLD），是当今一种迅速出现且广泛认可的肝脏疾病，被视为代谢综合征的肝脏表现。幽门螺杆菌是全球最常见的病原体之一，据报道与代谢综合征有关，但与FLD是否存在直接关联尚不清楚。本研究的目的是阐明FLD和NAFLD与包括幽门螺杆菌感染在内的致病背景因素之间的关联。
方法
这是一项对2010年在单一医疗中心接受体检的日本成年人进行的横断面研究。进行单因素和多因素统计分析以评估超声诊断的FLD的背景因素。对无酒精影响的受试者进行类似的NAFLD分析。
结果
在总共13737名受试者中，6318名女性中有l456名（23.0%）、7419名男性中有3498名（47.1%）检测出FLD。多变量分析显示，体重指数（女性和男性的标准化系数（β-F/M）=143.5/102.5）、血清谷丙转氨酶（β-F/M = 25.8/75.7）、年龄（β-F/M = 34.3/17.2）和血小板计数（β-F/M = 17.8/15.2）在两性中均与FLD呈正相关。在5289名无酒精影响的受试者中，3473名女性中有881名（25.4%）、1816名男性中有921名（50.7%）检测出NAFLD。体重指数（β-F/M = 113.3/55.3）、血清谷丙转氨酶（β-F/M = 21.6/53.8）和血小板计数（β-F/M = 13.8/11.8）在两性中均与NAFLD呈正相关。代谢综合征仅在男性中与FLD和NAFLD呈正相关。相比之下，无论性别如何，幽门螺杆菌感染状态均与FLD和NAFLD无关。
结论
体重指数、血清谷丙转氨酶和血小板计数与FLD和NAFLD显著相关，而幽门螺杆菌感染则不然。
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