非酒精性脂肪肝的检出率及其影响因素分析——基于渝西地区54 067份体检数据

Detection rate of nonalcoholic fatty liver disease and its influencing factors: a study based on the physical examination data of 54 067 cases in Western Chongqing，China

摘要

目的 为了明确渝西地区居民体检非酒精性脂肪肝（non-alcoholic fatty liver disease，NAFLD）的检出率状况及其影响因素。 方法 根据NAFLD的临床诊断标准及超声检测结果，以2020年1月1日至2023年11月30日在重庆医科大学附属永川医院体检中心接受健康体检的人群为研究对象。采用t检验、交叉列表（卡方）检验、多因素logistic回归分析等方法，明确健康体检者NAFLD的检出率及其影响因素。 结果 健康体检者NAFLD的检出率为23.64%（12 872/54 067）。男性的检出率（39.22%）显著高于女性（15.91%）（χ²=2 197.112，P<0.001）；50~59岁群体的NAFLD检出率最高（33.18%）；60岁以前，NAFLD的检出率会随着年龄的增加而增加，而60岁以后的检出率则会降低（χ²=367.554，P<0.001），表明渝西地区NAFLD的检出状况总体呈现年轻化的发展态势。体质指数（body mass index，BMI）为超重（39.39%）和肥胖（71.40%）群体的NAFLD检出率也明显高于消瘦（0.23%）和正常（9.68%）群体（χ²=7 644.383，P<0.001）。多因素logistic回归分析结果显示，健康体检者的性别、年龄、BMI、空腹血糖（fasting blood glucose，FBG）、收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）、甘油三酯（triglycerides，TG）、尿酸（uric acid，UA）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）均是NAFLD检出率的危险因素（P<0.05），而总胆固醇（total cholesterol，TC）不是NAFLD检出率的危险因素。 结论 渝西地区18岁以上健康体检者群体的NAFLD的检出率为23.64%，50~59岁是NAFLD的高发时期，男性、超重、肥胖是高危和易发群体，FBG、SBP、DBP、TG、UA、HDL-C、LDL-C均是导致NAFLD的危险因素，TC不是NAFLD的危险因素。

Abstract

Objective To investigate the detection rate of nonalcoholic fatty liver disease（NAFLD） and its influencing factors among residents in western Chongqing of China during physical examination. Methods Based on the clinical diagnostic criteria and ultrasound examination results of NAFLD，the individuals who underwent physical examination in a grade A tertiary hospital in Western Chongqing from January 1，2020 to November 30，2023 were enrolled as subjects. The methods such as the t-test，the chi-square test，and the multivariate logistic regression analysis were used to clarify the detection rate of NAFLD and its influencing factors among the individuals undergoing physical examination. Results The detection rate of NAFLD was 23.64%（12 872/54 067） among the individuals undergoing physical examination. The detection rate of NAFLD in male individuals was significantly higher than that in female individuals（39.22% vs.15.91%，χ² =2 197.112，P<0.001）. The individuals in the age group of 50-59 years had the highest NAFLD detection rate of 33.18%，and before the age of 60 years，the detection rate of NAFLD increased with age，while after the age of 60 years，the detection rate of NAFLD decreased with age（χ² =367.554，P<0.001），indicating the detection of NAFLD in younger populations in western Chongqing. The individuals with a body mass index indicative of overweight and obesity had a significantly higher detection rate of NAFLD than those with a body mass index indicative of emaciation and normal weight （39.39%/71.40% vs. 0.23%/9.68%，χ² =7 644.383，P<0.001）. The multivariate logistic regression analysis showed that sex，age，body mass index，fasting blood glucose（FBG），systolic blood pressure（SBP），diastolic blood pressure（DBP），triglyceride（TG），uric acid（UA），high-density lipoprotein cholesterol（HDL-C），and low-density lipoprotein cholesterol（LDL-C） were risk factors for the detection rate of NAFLD in individuals undergoing physical examination（P<0.05），while total cholesterol （TC） was not a risk factor for the detection rate of NAFLD. Conclusion The detection rate of NAFLD is 23.64% among the individuals aged 18 years or above who undergo physical examination in Western Chongqing，and there is a relatively high incidence rate of NAFLD in the age group of 50-59 years. Male individuals and overweight or obese individuals are at a high risk of NAFLD. FBG，SBP，DBP，TG，UA，HDL-C，and LDL-C are risk factors for NAFLD，while TC is not a risk factor for NAFLD.

关键词

非酒精性脂肪肝 / 健康体检者 / 检出率 / 影响因素 / 渝西地区

Key words

nonalcoholic fatty liver disease / people undergoing physical examination / detection rate / influencing factors / western Chongqing

基金资助

重庆医科大学第五临床学院临床研究课题资助项目(YJLC202017)