Zhu Wen-Hua, Fang Li-Zheng, Lu Chong-Rong, Dai Hong-Lei, Chen Jian-Hua, Qiao Qiao-Hua, Chen Li-Ying
Wen-Hua Zhu, Li-Zheng Fang, Chong-Rong Lu, Hong-Lei Dai, Jian-Hua Chen, Qiao-Hua Qiao, Li-Ying Chen, Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Sir Run Run Shaw Institute of Clinical Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
World J Gastroenterol. 2015 Sep 21;21(35):10192-9. doi: 10.3748/wjg.v21.i35.10192.
To assess the relationship between non-alcoholic fatty liver disease (NAFLD) with metabolic risk factors and brachial ankle pulse wave velocity (baPWV).
A total of 8603 subjects (6662 males and 1941 females) were enrolled during an annual health check-up. Fatty liver was examined using a Philips HD 11 XE multi-function color Doppler diagnostic instrument, and baPWV was determined using a novel arteriosclerosis detection device. Blood pressure (BP), fasting plasma glucose (FPG), waist circumference (WC), plasma triglycerides (TG), high-density lipoprotein (HDL), total cholesterol (TC), low-density lipoprotein (LDL) and uric acid (UA) were measured using standard methods. The relationship between fatty liver with metabolic risk factors and baPWV was analyzed using regression analysis and the χ (2) test.
The values and abnormal rates of baPWV were significantly different between NAFLD patients and non-NAFLD subjects (P < 0.001). In addition, the values of baPWV were different by gender between NAFLD patients and non-NAFLD subjects. The OR values in females, males, and the entire population were 3.33, 1.67, and 2.13, respectively (P < 0.001). The incidence of high baPWV increased with increasing degree of NAFLD (levels 0, 1, 2, and 3) (P < 0.001), which was 45.9%, 54.5%, 60.2%, and 71.4% in males and 27.0%, 49.1%, 55.60%, and 60.0% in females (P < 0.001), respectively. Logistic regression analysis showed that the OR value for baPWV in the non-metabolic syndrome group and the metabolic syndrome group was 1.28 vs 1.14 (males) and 2.55 vs 0.98 (females). The OR values for baPWV in the non-high-BP and high-BP, non-high-WC and high-WC, non-high-FPG and high-FPG, non-high-TG and high-TG, non-high-HDL and high-HDL, non-high-TC and high-TC, non-high-LDL and high-LDL, non-high-UA and high-UA groups were 3.38 vs 1.19, 3.50 vs 1.44, 2.80 vs 2.30, 3.29 vs 1.88, 3.03 vs 3.28, 3.35 vs 2.70, 3.93 vs 1.66, and 3.20 vs 2.34, respectively, in females (P < 0.001), and were 1.37 vs 1.34, 1.56 vs 1.26, 1.51 vs 1.28, 1.49 vs 1.52, 1.71 vs 1.61, 1.59 vs 1.74, 1.76 vs 1.47, and 1.73 vs 1.54, respectively, in males (P < 0.01). The OR value for baPWV was still higher than 1.2 (1.21 in males and 1.40 in females) after adjustment for the metabolic component (0, 1, 2, 3, 4, 5, 6 and above) (P < 0.01).
NAFLD is closely correlated with baPWV, particularly in females. NAFLD has a large impact on baPWV, no matter whether the metabolic index is increased or not. NAFLD may be a useful indicator for assessing early arteriosclerosis.
评估非酒精性脂肪性肝病（NAFLD）与代谢危险因素及肱踝脉搏波速度（baPWV）之间的关系。
共有8603名受试者（6662名男性和1941名女性）参加年度健康体检。使用飞利浦HD 11 XE多功能彩色多普勒诊断仪检查脂肪肝，并使用新型动脉硬化检测设备测定baPWV。采用标准方法测量血压（BP）、空腹血糖（FPG）、腰围（WC）、血浆甘油三酯（TG）、高密度脂蛋白（HDL）、总胆固醇（TC）、低密度脂蛋白（LDL）和尿酸（UA）。采用回归分析和χ²检验分析脂肪肝与代谢危险因素及baPWV之间的关系。
NAFLD患者与非NAFLD受试者的baPWV值及异常率差异有统计学意义（P<0.001）。此外，NAFLD患者与非NAFLD受试者的baPWV值存在性别差异。女性、男性及总体人群的OR值分别为3.33、1.67和2.13（P<0.001）。高baPWV的发生率随NAFLD程度的增加（0、1、2和3级）而升高（P<0.001），男性分别为45.9%、54.5%、60.2%和71.4%，女性分别为27.0%、49.1%、55.60%和60.0%（P<0.001）。Logistic回归分析显示，非代谢综合征组和代谢综合征组baPWV的OR值在男性中分别为1.28和1.14，在女性中分别为2.55和0.98。女性非高血压与高血压、非高腰围与高腰围、非高FPG与高FPG、非高TG与高TG、非高HDL与高HDL、非高TC与高TC、非高LDL与高LDL、非高UA与高UA组baPWV的OR值分别为3.38与1.19、3.50与1.44、2.80与2.30、3.29与1.88、3.03与3.28、3.35与2.70、3.93与1.66、3.20与2.34（P<0.001），男性分别为1.37与1.34、1.56与1.26、1.51与1.28、1.49与1.52、1.71与1.61、1.59与1.74、1.76与1.47、1.73与1.54（P<0.01）。调整代谢成分（0、1、2、3、4、5、6及以上）后，baPWV的OR值仍高于1.2（男性为1.21，女性为1.40）（P<0.01）。
NAFLD与baPWV密切相关，尤其是在女性中。无论代谢指标是否升高，NAFLD对baPWV均有较大影响。NAFLD可能是评估早期动脉硬化的有用指标。
