目的 探讨尿酸(UA)和血清高密度脂蛋白胆固醇(HDL-C)交互作用对非酒精性脂肪肝病(NAFLD)发病风险的影响,为疾病的早期预防提供依据.方法 导出并整理2017年1月-2021年12月甘肃中医药大学第四附属医院某石油化工企业人群的相关体检数据,采用巢式病例对照的研究方法,以2017-2021年随访期间新发的352例NAFLD患者为病例组,按照性别相同、年龄±2岁、体检月份相同进行1∶1个体匹配获得352例同期对照.采用条件logistic回归模型、限制性立方样条模型及相乘、相加交互模型探讨非酒精性脂肪肝病发病风险的影响因素及高UA和HDL水平异常的交互作用.结果 单因素条件logistic回归分析结果显示,超重/肥胖、高UA、TG异常、HDL-C异常、GLU异常可能是NAFLD发病的危险因素、Hcy异常可能是NAFLD发病的保护因素,差异均有统计学意义(P均＜0.05).多因素条件logistic回归分析结果显示,调整混杂因素后,高UA、TG异常、GLU异常、HDL-C水平异常者的NAFLD发病的风险增加,分别是非高UA、TG水平正常、GLU水平正常、HDL-C水平正常者的1.79倍(95％CI:1.05～3.07),4.86 倍(95％CI:2.98～7.94),5.96 倍(95％CI:2.55～13.93),2.02 倍(95％CI:1.19～3.39),且 UA 水平与NAFLD发病风险间存在正向线性剂量-反应关系(总趋势P＜0.001,非线性P=0.227),HDL-C水平与NAFLD发病风险间存在负向线性剂量-反应关系(总趋势P＜0.001,非线性P=0.329),但未发现两者的交互作用.结论 高UA和HDL-C水平异常是NAFLD发病的危险因素,应定期监测人群血清UA和HDL-C的水平.
Interaction between uric acid and high-density lipoprotein cholesterol on the risk of developing non-alcoholic fatty liver disease
Objective To investigate the effect of uric acid(UA)and serum high-density lipoprotein cholesterol(HDL-C)interaction on the risk of developing non-alcoholic fatty liver disease(NAFLD),provide a basis for the early prevention of the disease.Methods The relevant physical examination data of a petrochemical enterprise population in the Fourth Affiliated Hospital of Gansu University of Chinese Medicine from January 2017 to December 2021 were exported and sorted.A nested case-control study method was used.352 new cases of NAFLD during the follow-up period from 2017 to 2021 were selected as the case group,and 352 controls were obtained by 1:1 individual matching according to the same gender,age(±2 years),and physical examination month.Conditional logistic regression model,restricted cubic spline model,and multiplication and addition interaction model were used to explore the influencing factors of the risk of non-alcoholic fatty liver disease and the interaction between high UA and abnormal HDL.Results Univariate conditional logistic regression analysis showed that overweight/obesity,high UA,abnormal TG,abnormal HDL-C and abnormal GLU may be risk factors for the development of NAFLD,and abnormal Hcy may be protective factors for the development of NAFLD,with statistical significance(all P＜0.05).Multivariate conditional logistic regression analysis showed that after adjusting for confounding factors,the risk of NAFLD in patients with high UA,abnormal TG,abnormal GLU and abnormal HDL-C levels was increased by 1.79 times(95％CI:1.05-3.07),4.86 times(95％CI:2.98-7.94),5.96 times(95％CI:2.55-13.93)and 2.02 times(95％CI:1.19-3.39)compared with those with non-high UA,normal TG level,normal GLU level and normal HDL-C level,respectively.There was a positive linear dose-response relationship between UA level and the risk of NAFLD(overall trend P＜0.001,nonlinear P=0.227),and a negative linear dose-response relationship between HDL-C level and the risk of NAFLD(overall trend P＜0.001,nonlinear P=0.329),but no interaction was found between the two.Conclusion High UA and abnormal HDL-C were risk factors for NAFLD,and serum UA and HDL-C levels should be monitored regularly.
Uric acidHDL-CInteractionNAFLDNested case-control study
NETL
NSTL
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