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非肥胖人群腰围轨迹与新发非酒精性脂肪性肝病的关系

[Relationship between waist circumference trajectory and new-onset non alcoholic fatty liver disease in the non-obese population].

作者信息

Wang S, Zhang J, Jiang X Z, Tong B, Wang Q, Zhang W H, Yang Y Y, Xia J X, Wu S L

机构信息

Kailuan General Hospital, Tangshan 063000, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Jun 10;41(6):824-828. doi: 10.3760/cma.j.cn112338-20190630-00479.

Abstract

To investigate the relationship between waist circumference trajectory and new-onset nonalcoholic fatty liver disease (NAFLD) in the non-obese population. The study cohort was composed of the ones who met the selection criteria in Kailuan study. Waist circumference trajectories of the participants in 2006-2007, 2008-2009 and 2010-2011 were determined by SAS Proc Traj program. Four groups with different waist circumference trajectories were generated, including low-, medium-, medium-high- and high-stability groups. All groups were followed up for their health conditions in 2012-2013, 2014-2015 and 2016-2017, respectively. Incidence rates of NAFLD during physical examination were compared among different waist circumference trajectory groups. Cox regression model was used to analyze the correlation between different waist circumference trajectory groups and new-onset NAFLD. Finally, 12 477 observers were included in the statistical analysis, including 8 181 males and 4 296 females. There were 1 026 (8.2), 5 183 (41.5), 5 481 (44.0) and 787 cases (6.3) in the low, medium, medium-high and high stability-stability groups, respectively. There were 4 123 NAFLD cases occurred during the follow-up period. The cumulative incidence of NAFLD increased along with the increase of waist circumference trajectory (21, 43, 59, 72, respectively) (<0.01). The risks of NAFLD were 2.411 (95: 2.021-2.877), 4.050 (95: 3.402-4.820) and 5.489 (95: 4.506-6.686) times higher in medium-, medium-high- and high-stability group than that in the low-stability group (<0.01). After adjusting for age, sex and other confounding factors, the risks of NAFLD in the medium-, medium-high- and high-stability groups were 2.150 (95: 1.789-2.582), 3.176 (95: 2.623-3.846) and 3.732 (95: 2.987-4.662) times higher than that in the low-stability group. The risk of NAFLD in non-obese people increased along with the increase of waist circumference trajectory, which seemed to have played an independent risk factor for NAFLD.

摘要

为研究非肥胖人群腰围轨迹与新发非酒精性脂肪性肝病(NAFLD)之间的关系。研究队列由符合开滦研究入选标准的人群组成。通过SAS Proc Traj程序确定了参与者在2006 - 2007年、2008 - 2009年和2010 - 2011年的腰围轨迹。生成了具有不同腰围轨迹的四组,包括低稳定性、中稳定性、中高稳定性和高稳定性组。分别对所有组在2012 - 2013年、2014 - 2015年和2016 - 2017年的健康状况进行随访。比较不同腰围轨迹组在体检期间NAFLD的发病率。采用Cox回归模型分析不同腰围轨迹组与新发NAFLD之间的相关性。最终,12477名观察者纳入统计分析,其中男性8181名,女性4296名。低稳定性、中稳定性、中高稳定性和高稳定性组分别有1026例(8.2%)、5183例(41.5%)、5481例(44.0%)和787例(6.3%)。随访期间共发生4123例NAFLD病例。NAFLD的累积发病率随腰围轨迹的增加而升高(分别为21%、43%、59%、72%)(P<0.01)。中稳定性、中高稳定性和高稳定性组患NAFLD的风险分别比低稳定性组高2.411倍(95%CI:2.021 - 2.877)、4.050倍(95%CI:3.402 - 4.820)和5.489倍(95%CI:4.506 - 6.686)(P<0.01)。在调整年龄、性别和其他混杂因素后,中稳定性、中高稳定性和高稳定性组患NAFLD的风险分别比低稳定性组高2.150倍(95%CI:1.789 - 2.582)、3.176倍(95%CI:2.623 - 3.846)和3.732倍(95%CI:2.987 - 4.662)。非肥胖人群患NAFLD的风险随腰围轨迹的增加而增加,腰围轨迹似乎是NAFLD的一个独立危险因素。

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