Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, No.7, Huilongguan Nandian Road, Changping District, Beijing, 100096, China.
Hepatol Int. 2021 Feb;15(1):127-136. doi: 10.1007/s12072-020-10132-z. Epub 2021 Jan 29.
Non-alcoholic fatty liver disease (NAFLD) is becoming the most common liver disease in China. However, the understanding of NAFLD prevalence among Chinese mental disorder inpatients remains insufficient. We aim to investigate the prevalence of NAFLD among mental disorder inpatients in Beijing, China.
In this observational study, we included 66,273 mental disorder inpatients between 2014 and 2018, including inpatients with schizophrenia, bipolar disorder, depressive disorder and other mental disorders. Data were obtained from electronic health records of 19 specialized psychiatric hospitals in Beijing. NAFLD was defined by ICD-10 code, excluding other causes of liver disease. We calculated the overall and annual prevalence rates of NAFLD from 2014 to 2018, and compared NAFLD prevalence between sexes, age groups, mental disorders types, antipsychotics use, and comorbidities. Multivariable logistic regression was used to examine risk factors associated with NAFLD. Subgroup analysis was performed in different mental disorder types.
The prevalence of NAFLD was 17.63% (95% CI 17.34-17.92%) in mental disorder inpatients, increasing from 16.88% in 2014 to 19.07% in 2018. The NAFLD prevalence in participants with schizophrenia (22.44%) was higher than that in participants with bipolar disorder (17.89%), depressive disorder (12.62%), and other mental disorders (12.99%). Women had similar or even higher NAFLD prevalence than men after 50 years. Men, 50-59 years (aOR = 1.71), schizophrenia (aOR = 1.56), bipolar disorder (aOR = 1.47), antipsychotics use (aOR = 1.46), hypertension (aOR = 1.50), diabetes (aOR = 1.83), dyslipidemia (aOR = 2.50) were risk factors for NAFLD in mental disorder inpatients.
NAFLD was common among Chinese mental disorder inpatients, and increased over years. The prevalence of NAFLD was higher among men, old women, inpatients with schizophrenia, bipolar disorder, antipsychotics, hypertension, diabetes, and dyslipidemia. Fatty liver disease among mental disorder population warrants the attention of psychiatric specialists and health policy-makers.
非酒精性脂肪性肝病（NAFLD）正在成为中国最常见的肝病。然而，对于中国精神障碍住院患者中 NAFLD 的流行情况仍了解不足。本研究旨在调查中国北京精神障碍住院患者中 NAFLD 的患病率。
本观察性研究纳入了 2014 年至 2018 年间的 66273 例精神障碍住院患者，包括精神分裂症、双相情感障碍、抑郁症和其他精神障碍患者。数据来自北京 19 家专业精神病院的电子健康记录。NAFLD 采用 ICD-10 编码定义，排除其他原因引起的肝病。我们计算了 2014 年至 2018 年期间 NAFLD 的总体和年度患病率，并比较了不同性别、年龄组、精神障碍类型、抗精神病药物使用和合并症之间的 NAFLD 患病率。采用多变量逻辑回归分析与 NAFLD 相关的危险因素。在不同的精神障碍类型中进行了亚组分析。
精神障碍住院患者中 NAFLD 的患病率为 17.63%（95%CI 17.34%-17.92%），呈逐年上升趋势，2014 年为 16.88%，2018 年为 19.07%。精神分裂症患者（22.44%）的 NAFLD 患病率高于双相情感障碍（17.89%）、抑郁症（12.62%）和其他精神障碍（12.99%）患者。50 岁以上女性的 NAFLD 患病率与男性相似，甚至更高。男性、50-59 岁（OR=1.71）、精神分裂症（OR=1.56）、双相情感障碍（OR=1.47）、抗精神病药物使用（OR=1.46）、高血压（OR=1.50）、糖尿病（OR=1.83）、血脂异常（OR=2.50）是精神障碍住院患者 NAFLD 的危险因素。
NAFLD 在中国精神障碍住院患者中较为常见，且呈逐年上升趋势。男性、老年女性、精神分裂症、双相情感障碍、抗精神病药物、高血压、糖尿病和血脂异常患者的 NAFLD 患病率更高。精神障碍人群中的脂肪肝值得精神科专家和卫生政策制定者关注。
