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非酒精性脂肪性肝病(NAFLD)肥胖与非肥胖患者的临床特征比较。

Comparison of Clinical Characteristics Between Obese and Non-Obese Patients with Nonalcoholic Fatty Liver Disease (NAFLD).

作者信息

Li Yifang, Chen Yanzhen, Tian Xing, Zhang Shanshan, Jiao Jian

机构信息

Department of Gastroenterolgy & Hepatology, China-Japan Union Hospital, Jilin University, Changchun, 130033, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2021 May 6;14:2029-2039. doi: 10.2147/DMSO.S304634. eCollection 2021.

Abstract

OBJECTIVE

Non-alcoholic fatty liver disease (NAFLD), previously thought to predominantly affect obese individuals, has also been shown to occur in subjects who have a relatively normal body mass index (BMI). Due to the normal BMI, non-obese NAFLD are easily to be ignored and eventually lead to potential liver injuries.

METHODS

A population-based cross-sectional study was conducted on 1608 cases with normal serum alanine aminotransferase (ALT) levels who were divided into an obese group (BMI ≥25 kg/m) and a non-obese group (BMI <25 kg/m). NAFLD was diagnosed by ultrasound and Fibro Scan examination. Non-obese populations were divided into NAFLD group (CAP ≥240 db/m) and non-NAFLD group (CAP <240 db/m). The incidence of NAFLD in the obese and non-obese populations and constituent ratios of genders, age, and serum levels of triglycerides (TG), cholesterol (CHOL), and blood glucose were compared. Risk factors of NAFLD in non-obese people were analyzed by multivariate logistics regression.

RESULTS

The occurrence of NAFLD was higher in the obese group than in the non-obese group, regardless of gender (P <0.001). In the non-obese group, the occurrence of NAFLD in female patients was lower than that in male (P=0.001). The occurrence of NAFLD increased with age, with 50-59 years being the peak age of incidence in both male and female. The peak age of NAFLD occurrence in non-obese male patients was more delayed than that in obese male patients. BMI (OR=1.311, P=0.000) and TG (OR=2.545, P=0.000) were risk factors for NAFLD in the non-obese population.

CONCLUSION

Compared with obese population, the incidence of NAFLD in non-obese population was relatively low and more frequently in male than in female, the peak age of NAFLD occurrence in non-obese male patients was also delayed. BMI and TG should still be controlled to avoid the occurrence of NAFLD although the BMI of such patients is normal.

摘要

目的

非酒精性脂肪性肝病(NAFLD)以往被认为主要影响肥胖个体,但也已证实在体重指数(BMI)相对正常的人群中也会发生。由于BMI正常,非肥胖型NAFLD容易被忽视,最终导致潜在的肝脏损伤。

方法

对1608例血清丙氨酸氨基转移酶(ALT)水平正常的患者进行基于人群的横断面研究,将其分为肥胖组(BMI≥25kg/m²)和非肥胖组(BMI<25kg/m²)。通过超声和Fibro Scan检查诊断NAFLD。非肥胖人群分为NAFLD组(受控衰减参数(CAP)≥240dB/m)和非NAFLD组(CAP<240dB/m)。比较肥胖和非肥胖人群中NAFLD的发病率以及性别、年龄、甘油三酯(TG)、胆固醇(CHOL)和血糖血清水平的构成比。通过多因素logistic回归分析非肥胖人群中NAFLD的危险因素。

结果

无论性别如何,肥胖组中NAFLD的发生率均高于非肥胖组(P<0.001)。在非肥胖组中,女性患者NAFLD的发生率低于男性(P = 0.001)。NAFLD的发生率随年龄增加而升高,50 - 59岁是男性和女性的发病高峰年龄。非肥胖男性患者NAFLD发病的高峰年龄比肥胖男性患者更延迟。BMI(比值比(OR)=1.311,P = 0.000)和TG(OR = 2.545,P = 0.000)是非肥胖人群中NAFLD的危险因素。

结论

与肥胖人群相比,非肥胖人群中NAFLD的发病率相对较低,男性比女性更常见,非肥胖男性患者NAFLD发病的高峰年龄也延迟。尽管此类患者的BMI正常,但仍应控制BMI和TG以避免NAFLD的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e553/8110261/3807369f63bd/DMSO-14-2029-g0001.jpg

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