摘要
目的 分析非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)人群的肝功能损伤及血脂异常.方法 2016年1月1日至2017年12月31日在上海长海医院体检中心共收集15 163例NAFLD人群作为NAFLD组,24273名非脂肪肝的正常体检人群作为非脂肪肝组.两组人群年龄均≥15岁,每5岁为一个年龄段,共分为14个年龄段,各年龄段均按照肝功能正常、异常和血脂理想、合适、边缘、异常进行分层,卡方检验分析各年龄段肝功能和血脂的差异,并对不同年龄段的肝功能和血脂异常率进行分析和组间对比.结果 不同年龄段NAFLD组丙氨酸氨基转移酶(alanineaminotransferase,ALT)、门冬氨酸氨基转移酶(aspartic acid aminotransferase,AST)水平差异有统计学意义(x2=693.79、126.67,P＜0.05).随着年龄段的增长,ALT异常率在69岁以前成下降趋势,AST异常率在49岁以前成下降趋势.24岁以下人群ALT异常率≥32.3％,25～54岁人群ALT异常率为10.9％～28.5％,55岁以上人群ALT异常率≤8.7％.19岁以下人群AST异常率≥30％,20～29岁人群AST异常率为10.6％～ 15.9％,30岁以上人群AST异常率≤7.8％.不同年龄段NAFLD组的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)、三酰甘油(triglycerin,TG)、总胆固醇(total cholesterol,TC)水平差异有统计学意义(x2=181.04、231.35、194.90、203.44,P＜0.05).HDL-C、LDL-C、TG、TC异常率分别在30～34岁、55～64岁、45～49岁、60～64岁出现峰值.NAFLD组和非脂肪肝组HDL-C异常率在30～34岁分别为28.0％、3.4％;LDL-C异常率在40～44岁分别为14.2％、4.7％;TG异常率在40～44岁分别为31.7％、4.9％,以上三个年龄段为差距峰值.其中TG在30～34岁年龄段病例组和对照组的边缘率分别为23.5％和5.5％,差距在各年龄段中最为明显.结论 NAFLD带来的ALT和AST损害分别在54岁和29岁以下人群最为普遍.NAFLD人群的血脂异常率高于正常人群,两组HDL-C在30～34岁,LDL-C在40～44岁,TG在40～44岁异常率出现差距峰值,其中TG在30～34岁年龄段病例组和对照组的边缘率差距最为明显.
Abstract
Objective To analyze liver function damage and blood lipid difference in fatty liver patients of different ages.Methods From January 1,2016,to December 31,2017,a total of 15 163 non-alcoholic fatty liver (NAFLD) patients from the Changhai Hospital Medical Center were collected as NAFLD group,and 24 273 normal non-fatty liver patients were used as non-fatty liver group.The two groups were divided into 14 age groups.All age groups were stratified according to normal,abnormal and blood lipids,ideal,marginal and abnormal.The chi-square test was used to analyze the differences in liver function and blood lipids between age groups.Age and analysis of function and dyslipidemia rates and comparison between groups.Results There were differences in alanine aminotransferase (ALT) and aspartic acid aminotransferase (AST) levels between different fatty liver age groups (P＜0.05);x2 was 693.79 and 126.67,respectively.With the increase in age,ALT had a downward trend before the age of 69,and AST had a downward trend before the age of 49.The abnormal rate of ALT was ≥32.3％ in people under 24 years old,10.9％-28.5％ in people 25-54 years old and,≤8.7％ in people over 55 years old.The abnormal rate of AST was ≥30％ in people under 19 years old,10.6％-15.9％ in people 20-29 years old,and ≤7.8％ in people over 30 years old.The levels of high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triacylglycerol (TG),and total cholesterol (TC) in non-alcoholic fatty liver disease of different age groups were statistically significant (x2=181.04,231.35,194.90,203.44,respectively,P＜0.05).The abnormal rates of HDL-C,LDL-C,TG,and TC were 30-34 years old,55-64 years old,45-49 years old,60-64 years old,respectively.The abnormal rate of HDL-C in the NAFLD group and the non-fitty liver group was 28.0％ and 3.4％,respectively,in 30-34 years old,LDL-C was 14.2％ and 4.7％,respectively,in 40-44 years old,and TG was 31.7％ and 4.9％,respectively,in 40-44 years old;the three age groups were the peak of the gap.The marginal rates of TG in the 30-34 age group NAFLD group and non-fitty liver group were 23.5％ and 5.5％,respectively,and it was most obvious in all age groups.Conclusion ALT and AST damage caused by NAFLD is most common in people under 54 years old and 29 years old,with abnormal rates of ≥10.9％ and ≥10.6％,respectively.The abnormal rate of blood lipids in NAFLD patients is higher than that in normal people.The abnormal rate of HDL-C is 30-34 years old,LDL-C is 40-44 years old and,TG is 40-44 years old.The marginal rate difference of TG in the 30-34 age group and the normal group was the most obvious.
NETL
NSTL
维普
万方数据