Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China.
Liver Int. 2017 Aug;37(8):1202-1208. doi: 10.1111/liv.13363. Epub 2017 Feb 11.
BACKGROUND & AIMS: Cross-sectional studies have shown that apolipoprotein B (apoB) is positively associated with the prevalence of non-alcoholic fatty liver disease (NAFLD). This study aimed to investigate the prospective relationship between the serum apoB levels and the development of NAFLD in a Chinese population.
A cohort of 7077 initially NAFLD-free participants was enrolled in this prospectively study. The incidence of NAFLD was calculated among participants with different baseline serum apoB quintiles. Cox proportional hazards regression analyses were conducted to calculate the risks for incident NAFLD.
During 41 555 person-year follow-ups, 1139 incident NAFLD cases were identified. The baseline apoB levels were linear and positively correlated with NAFLD incidence. The incidence was 16.99, 22.63, 24.73, 37.51 and 42.77 per 1000 person-year follow-up for participants with baseline apoB levels in quintiles 1-5, respectively. Compared with participants with baseline apoB levels in quintile 1, the hazard ratios (95% confidence interval) for incident NAFLD were 1.353 (1.100-1.663), 1.482 (1.207-1.820), 2.232 (1.832-2.720) and 2.543 (2.082-3.106) for participants with baseline apoB levels in quintile 2-5, respectively. The hazard ratios were attenuated but remained statistically significant after adjusting for age, gender, body mass index and variables associated with metabolic syndrome.
Elevated serum apoB levels independently predict an increased risk for incident NAFLD.
横断面研究表明，载脂蛋白 B（apoB）与非酒精性脂肪性肝病（NAFLD）的患病率呈正相关。本研究旨在探讨中国人群血清 apoB 水平与 NAFLD 发展的前瞻性关系。
本前瞻性研究纳入了最初无 NAFLD 的 7077 名参与者。根据基线时不同血清 apoB 五分位数，计算参与者中 NAFLD 的发生率。采用 Cox 比例风险回归分析计算发生 NAFLD 的风险。
在 41555 人年的随访期间，共发现 1139 例新发 NAFLD 病例。基线 apoB 水平与 NAFLD 发生率呈线性正相关。基线 apoB 水平处于五分位数 1-5 的参与者，NAFLD 的发生率分别为每 1000 人年随访 16.99、22.63、24.73、37.51 和 42.77。与基线 apoB 水平处于五分位数 1 的参与者相比，基线 apoB 水平处于五分位数 2-5 的参与者发生 NAFLD 的风险比（95%置信区间）分别为 1.353（1.100-1.663）、1.482（1.207-1.820）、2.232（1.832-2.720）和 2.543（2.082-3.106）。校正年龄、性别、体重指数和与代谢综合征相关的变量后，风险比虽有所减弱，但仍具有统计学意义。
血清 apoB 水平升高独立预测新发 NAFLD 的风险增加。
