首页|非酒精性脂肪性肝病检出率现状及其影响因素:基于北京市32万人群数据

非酒精性脂肪性肝病检出率现状及其影响因素:基于北京市32万人群数据

Detection Rate of Non-alcoholic Fatty Liver Disease and Its Influencing Factors:Analysis Based on the Data of 320 000 Beijing Population

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背景 非酒精性脂肪性肝病(NAFLD)患病率高,且逐年上升,有向低龄化发展的趋势.通过体检尽早发现并加以干预,对减少其危害具有较大公共卫生意义.目的 探究 2018-2021 年北京市体检人群中NAFLD检出情况,并分析其相关的影响因素.方法 依据纳入标准选取 2018-2021 年在北京市体检中心接受健康体检的人群为研究对象.收集其体格检查、实验室检查和肝脏超声检查结果.采用t检验或秩和检验、χ2 检验进行单因素分析,利用非条件多因素Logistic回归探究发生NAFLD的影响因素.结果 最终纳入研究 325 726 人,其中NAFLD检出 108 512 例,检出率为 33.31%;按照肝脏超声诊断结果,轻、中、重度NAFLD检出人数分别为 74 062、33 281、1 169 例,分别占检出人群的 68.25%、30.67%、1.08%.男性NAFLD检出率高于女性(χ2=17 518.893,P<0.05).趋势性χ2 检验结果显示,在70岁之前,NAFLD检出率随着年龄的增大而增大,70岁之后NAFLD检出率下降(χ2趋势= 14 397.61,P<0.001).在 18~59 岁人群中,男性NAFLD检出率均高于女性(P<0.05);≥70 岁人群中,男性NAFLD检出率均低于女性(P<0.05).非条件多因素Logistic回归分析结果显示,性别(男:OR=1.173)、年龄(30~39岁:OR=1.604,40~49 岁:OR=1.948,50~59 岁:OR=2.486,60~69 岁:OR=2.663,70~79 岁:OR=2.079,≥80 岁:OR=1.149)、BMI(18.5~23.9 kg/m2:OR=2.997,24.0~27.9 kg/m2:OR=3.911,≥28.0 kg/m2:OR=11.780)、收缩压(SBP)(≥140 mmHg:OR=1.200)、舒张压(DBP)(≥90 mmHg:OR=1.177)、空腹血糖(FBG)(≥6.10 mmol/L:OR=1.934)、三酰甘油(TG)(≥1.70 mmol/L:OR=2.946)、总胆固醇(TC)(≥5.20 mmol/L:OR=1.050)、高密度脂蛋白胆固醇(HDL-C)(<1.0 mmol/L:OR=1.645)、低密度脂蛋白胆固醇(LDL-C)(≥3.4 mmol/L:OR=1.499)、血尿酸(SUA)(男性>420 μmol/L、女性>360 μmol/L:OR=2.067)是发生NAFLD的影响因素(P<0.05).结论 北京市 18 岁以上体检人群NAFLD检出率约占 33.31%,其中 50~69 岁是NAFLD高发人群,男性、超重、肥胖者是高危人群,血脂、血压、血糖异常也为NAFLD的危险因素.
Background Non-alcoholic fatty liver disease has showed a high prevalence and a increasing trend especially towards younger age.It is of great public health significance to reduce damage through early detection of NAFLD in physical examination and intervention in time.Objective To investigate the detection rate of NAFLD in the Beijing physical examination population from 2018 to 2021,and analyze its related influencing factors.Methods People who received physical examinations at the Beijing Physical Examination Center from 2018-01-01 to 2021-12-31 were selected based on the inclusion criteria,the results of physical examination,laboratory examination,and liver ultrasonography were collected for analysis.Univariate analysis was performed using t-test,Mann-Whitney U test and Chi-square test.Multivariate Logistic regression was used to explore the influencing factors of NAFLD.Results A total 325 726 people were included in the study,of which 108 512 cases of NAFLD were detected,with a detection rate of 33.31%.The results of liver ultrasonography revealed that the number of mild,moderate and severe NAFLD detections were 74 062,33 281 and 1 169 cases,accounting for 68.25%,30.67%and 1.08%of the detection population,respectively.The detection rate of NAFLD was higher in males than females(χ2= 17 518.893,P<0.05).Chi-square test for trend revealed an age-dependent increase detection rate of NAFLD before 70 years old,and a subsequent decline after reaching 70 years old(χ2trend=14 397.61,P<0.001).Higher detection rate was revealed in males than females among people aged 18-59 years(P<0.05),while lower detection rate in males than females among people aged≥70 years old(P<0.05).Multivariate Logistic regression results showed that gender(male:OR=1.173),aging(30-39:OR=1.604,40-49:OR=1.948,50-59:OR=2.486,60-69:OR=2.663,70-79:OR=2.079,≥80:OR=1.149),BMI(18.5-23.9 kg/m2:OR=2.997,24.0-27.9 kg/m2:OR=3.911,≥28.0 kg/m2:OR=11.780),systolic blood pressure(SBP)(≥140 mmHg:OR=1.200),diastolic blood pressure(DBP)(≥90 mmHg:OR=1.177),fasting blood glucose(FBG)(≥6.10 mmol/L:OR=1.934),triacylglycerol(TG)(≥1.70 mmol/L:OR=2.946),total cholesterol(TC)(≥5.20 mmol/L:OR=1.050),high-density lipoprotein cholesterol(HDL-C)(<1.0 mmol/L:OR=1.645),low-density lipoprotein cholesterol(LDL-C)(≥3.4 mmol/L:OR=1.499),serum uric acid(SUA)(SUAmale>420 μmol/L,SUAfemale>360 μmol/L:OR=2.067)were influencing factors for NAFLD(P<0.05).Conclusion The detection rate of NAFLD in physical examination population in Beijing was 33.31%,the highest incidence showed in people aged 50 to 69 years.Males,overweight and obese people are the high-risk groups,and abnormalities in blood lipids,blood pressure and blood glucose are also risk factors for NAFLD.

Non-alcoholic fatty liver diseasePhysical examination populationPrevalenceRoot cause analysisBeijing

窦紫岩、钱文红、孔邻润、陈晔、李明亮、张静波

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100050 北京市体检中心

非酒精性脂肪性肝病 体检人群 患病率 影响因素分析 北京

国家重点研发计划

2020YFC2003400

2024

中国全科医学
中国医院协会

中国全科医学

CSTPCD北大核心
影响因子:2.04
ISSN:1007-9572
年,卷(期):2024.27(2)
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