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非酒精性脂肪性肝病患者的风险因素和代谢异常:非肥胖或肥胖的中国人群。

Risk factors and metabolic abnormality of patients with non-alcoholic fatty liver disease: Either non-obese or obese Chinese population.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, China.

Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2018 Feb;17(1):45-48. doi: 10.1016/j.hbpd.2018.01.007. Epub 2018 Jan 31.

Abstract

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese population.

METHODS

Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver (normal or NAFLD), and body mass index (BMI) levels (non-obese if BMI < 25 kg/m or obese if BMI ≥ 25 kg/m).

RESULTS

There were 745, 208, 770 and 285 patients enrolled in four groups labeled non-obese normal liver (group A), non-obese NAFLD (group B), obese normal liver (group C) and obese NAFLD (group D), respectively. The highest ratio of metabolic syndrome existed in the group B (26.9%), followed by group A (11.7%), group D (10.9%) and finally the group C (5.2%). The positive association with NAFLD in non-obese individuals was significant in triglyceride (OR = 1.01; 95% CI: 1.01-1.02) and glucose (OR = 1.02; 95% CI: 1.01-1.03), while the positive association with NAFLD in obese subjects was only significant in triglyceride (OR = 1.01; 95% CI: 1.01-1.02). The positive association was most significant in all cases (adjusted OR = 2.41; 95% CI: 1.78-3.24), especially in non-obese individuals (OR = 2.81; 95% CI: 1.92-4.12).

CONCLUSIONS

Non-obese NAFLD subjects displayed a higher proportion of metabolic abnormality. Hyperlipidemia and hyperglycemia had the most positive strength association with NAFLD.

摘要

背景

非酒精性脂肪性肝病(NAFLD)不仅发生在肥胖者中,也发生在非肥胖者中。本研究的目的是关注非肥胖或肥胖的中国人中 NAFLD 与代谢事件之间的关联。

方法

分析了 2009 年 1 月至 12 月期间在台中荣民总医院登记的受试者的数据。排除标准为酗酒者、慢性乙型或丙型肝炎患者。根据肝脏超声(正常或 NAFLD)和体重指数(BMI)水平(BMI<25kg/m 为非肥胖,BMI≥25kg/m 为肥胖)将纳入分析的患者分为四组。

结果

分别有 745、208、770 和 285 例患者纳入非肥胖正常肝脏组(A 组)、非肥胖非酒精性脂肪性肝病组(B 组)、肥胖正常肝脏组(C 组)和肥胖非酒精性脂肪性肝病组(D 组)。代谢综合征的比例最高的是 B 组(26.9%),其次是 A 组(11.7%)、D 组(10.9%)和 C 组(5.2%)。非肥胖个体中,NAFLD 与甘油三酯(OR=1.01;95%CI:1.01-1.02)和血糖(OR=1.02;95%CI:1.01-1.03)呈正相关,而肥胖个体中,仅与甘油三酯呈正相关(OR=1.01;95%CI:1.01-1.02)。在所有病例中,正相关最为显著(调整后的 OR=2.41;95%CI:1.78-3.24),尤其是在非肥胖个体中(OR=2.81;95%CI:1.92-4.12)。

结论

非肥胖性非酒精性脂肪性肝病患者表现出更高比例的代谢异常。血脂异常和高血糖与 NAFLD 有最强的正相关。

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