【摘要】 目的分析2009年—2016年克拉玛依市中心医院体检者脂肪性肝病(FLD)患病率变化及影响因素,为FLD防治提供参考。方法 2009年1月—2016年12月克拉玛依市中心医院体检行腹部超声检查且性别资料齐全者共230 330人次,分析FLD患病率变化,对比历年男女性FLD患病率差异;选取2016年年龄、BMI、空腹血糖及甘油三酯等体检资料完整的33 195例体检者,分析不同年龄、BMI、性别体检者FLD患病率。采用多因素logistic回归分析FLD发生的独立影响因素。计数资料2组间比较采用χ~2检验;正态分布的计量资料2组间比较采用t检验;非正态分布的计量资料2组间比较采用Mann-Whitney U秩和检验。结果 2009年—2016年,克拉玛依市中心医院体检者FLD患病率从19.4%增长至31.9%(P <0.001),男性患病率从22.8%增长至39.5%(P <0.001);女性患病率从11.8%增长至21.6%(P <0.001),男性历年患病率均高于女性(P值均<0.001)。在2016年体检者中,青(18～44岁)、中(45～59岁)和老年(> 59岁)体检者分别为17 848、10 017、5330例,FLD患病率依次升高,分别为26.1%、37.3%及41.7%(P <0.01);青中年男性体检者FLD患病率高于同年龄段女性(P值均<0.001),老年男性体检者FLD患病率低于同年龄段女性(P=0.022)。消瘦、正常、超重及肥胖体检者分别为865、13 510、12 755、6065例,FLD患病率依次升高,分别为0.8%、9.5%、39.6%及70.6%(P <0.01);各BMI分层男性FLD患病率均高于女性(P值均<0.05)。Logistic回归分析显示,年龄、性别、BMI、收缩压、舒张压、ALT、TBil、空腹血糖、甘油三酯、总胆固醇、血尿酸水平是FLD发生的独立影响因素(P值均<0.05)。结论克拉玛依市居民FLD患病率近年增长迅速,危险因素众多,应加强当地政策干预,主动宣传教育,筛查高危人群,尽早落实防治措施,以降低相关医疗负担。更多还原

【Abstract】 Objective To investigate the change in the prevalence rate of fatty liver disease( FLD) and related influencing factors among individuals undergoing physical examination in Karamay Central Hospital from 2009 to 2016,and to provide a reference for the prevention and treatment of FLD. Methods Abdominal ultrasound( 230 330 cases) was performed in Karamay Central Hospital from January 2009 to December 2016,and related data were used to analyze the change in the prevalence rate of FLD and compare the difference between male and female individuals. A total of 33 195 individuals who underwent physical examination in 2016 and had complete data of age,body mass index( BMI),fasting blood glucose,and triglyceride were selected to analyze the prevalence rate of FLD among the individuals with different ages,BMIs,and sexes. A multivariate logistic regression analysis was used to investigate independent influencing factors for the development of FLD. The chi-square test was used for comparison of categorical data between groups; the t-test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. Results From 2009 to 2016,the prevalence rate of FLD increased from 19. 4% to 31. 9% among the individuals who underwent physical examination in Karamay Central Hospital( P < 0. 001); the prevalence rate increased from 22. 8% to 39. 5% among male individuals( P < 0. 001),and the prevalence rate increased from 11. 8% to 21. 6% among female individuals( P < 0. 001),suggesting that male individuals had a significantly higher prevalence rate than female individuals in each year( P < 0. 001). Among the individuals who underwent physical examination in 2016,the prevalence rate of FLD was 26. 1% in 17 848 young individuals,37. 3% in 10 017 middle-aged individuals,and 41. 7% in 5330 elderly individuals( P < 0. 001); the young and middle-aged male individuals had a significantly higher risk of FLD than the female individuals in the same age group( both P < 0. 001),and the elderly male individuals had a significantly lower risk of FLD than the female individuals in the same age group( P = 0. 022). There were 865 individuals with emaciation,13510 with normal body weight,12 755 with overweight,and 6065 with obesity,with a prevalence rate of FLD of 0. 8%,9. 5%,39. 6%,and70. 6%,respectively( P < 0. 001),and the stratified analysis based on BMI showed that male individuals had a significantly higher prevalence rate of FLD than females individuals( P < 0. 05). The multivariate logistic regression analysis showed that age,sex,BMI,systolic pressure,diastolic pressure,alanine aminotransferase,total bilirubin,fasting blood glucose,triglyceride,total cholesterol,and serum uric acid were independent influencing factors for FLD( all P < 0. 05). Conclusion There is a rapid increase in the prevalence rate of FLD among the residents of Karamay,and there are various risk factors. It is recommended to strengthen policy intervention,provide public education,screen out the high-risk population,and implement preventive and treatment measures as early as possible,so as to reduce related medical burden.更多还原