Tong C, Li Q, Kong L, Ni X, Halengbieke A, Zhang S, Wu Z, Tao L, Han Y, Zheng D, Guo X, Yang X
School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
J Endocrinol Invest. 2022 Dec;45(12):2233-2245. doi: 10.1007/s40618-022-01848-w. Epub 2022 Jul 27.
Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease. This study examined sex-specific associations between NAFLD and metabolic factors and investigated the trajectory of risk factors.
We retrospectively investigated 16,140 individuals from Beijing Health Management Cohort. Univariate and multivariate time-dependent Cox regression analyses were performed to identify independent risk factors for new-onset NAFLD. The trajectory of risk factors was investigated using the latent growth curve model and growth mixture model.
Over a median follow-up of 3.15 years, 2,450 (15.18%) participants developed NAFLD. The risk factors for NAFLD in men were increased body mass index (BMI); waist circumference (WC); triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), haemoglobin (Hb), and serum uric acid (SUA) levels; and platelet (PLT) count and decreased serum creatinine-to-body weight (sCr/bw) and high-density lipoprotein cholesterol (HDL-C) levels. In women, the risk factors were increased BMI, WC, and fasting plasma glucose (FPG), TG, LDL-C, SUA, white blood cell (WBC), and PLT and decreased sCr/bw and HDL-C levels. In addition, BMI, LDL-C, sCr/bw and PLT changing trajectories were associated with NAFLD in men; BMI, WC, TG, LDL-C, SUA and sCr/bw trends was associated with NAFLD risk in women.
Development of NAFLD is associated with BMI, LDL-C, sCr/bw and PLT changing trajectories in men; BMI, WC, TG, LDL-C, SUA and sCr/bw trends are associated an increased risk of NAFLD in women. Deterioration of metabolic risk factors status can be a predictor of NAFLD many years before its occurrence.
非酒精性脂肪性肝病（NAFLD）是一种常见的慢性肝病。本研究探讨了NAFLD与代谢因素之间的性别特异性关联，并研究了危险因素的变化轨迹。
我们对北京健康管理队列中的16140名个体进行了回顾性调查。采用单变量和多变量时间依赖性Cox回归分析来确定新发NAFLD的独立危险因素。使用潜在增长曲线模型和增长混合模型研究危险因素的变化轨迹。
在中位随访3.15年期间，2450名（15.18%）参与者发生了NAFLD。男性NAFLD的危险因素包括体重指数（BMI）升高；腰围（WC）；甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、血红蛋白（Hb）和血清尿酸（SUA）水平；血小板（PLT）计数增加，以及血清肌酐与体重比值（sCr/bw）和高密度脂蛋白胆固醇（HDL-C）水平降低。在女性中，危险因素包括BMI、WC、空腹血糖（FPG）、TG、LDL-C、SUA、白细胞（WBC）和PLT升高，以及sCr/bw和HDL-C水平降低。此外，BMI、LDL-C、sCr/bw和PLT的变化轨迹与男性NAFLD相关；BMI、WC、TG、LDL-C、SUA和sCr/bw的变化趋势与女性NAFLD风险相关。
男性NAFLD的发生与BMI、LDL-C、sCr/bw和PLT的变化轨迹有关；女性中BMI、WC、TG、LDL-C、SUA和sCr/bw的变化趋势与NAFLD风险增加有关。代谢危险因素状态的恶化可能是NAFLD发生前多年的一个预测指标。
