【摘要】 目的 探讨非酒精性脂肪肝（NAFLD）的中医体质及NAFLD相关危险因素预测价值。方法 以835例60～91岁参检者为研究对象，采用横断面调查方法，所有参检者进行数据收集，包括年龄、性别、既往史、身高、体质量、腰围、血压、生化指标、B超检查等，并对参检者进行中医体质辨识，根据B超结果将参检者分为对照组和NAFLD组，进行相关数据分析。结果 NAFLD组痰湿质高于对照组[72例（19.46%） vs 39例（8.39%）]（P<0.001）,湿热质显著高于对照组[20例（5.41%） vs 11例（2.37%）]（P<0.05）。痰湿质、湿热质、腰围、空腹血糖（FPG）、血红蛋白（Hb）、尿酸（UA）、γ-谷氨酰基转移酶（GGT）、丙氨酸氨基转移酶（ALT）、甘油三酯（TG）、糖化血红蛋白（HbA₁c）、体质量指数（BMI）、舒张压（DBP）、收缩压（SBP）会对NAFLD产生显著的正向影响（P<0.05）,各项回归系数分别为：0.970、0.858、0.097、0.274、0.033、0.003、0.016、0.057、0.976、0.545、0.333、0.033、0.008。痰湿质、湿热质、阳虚质、年龄、GGT、ALT、高密度脂蛋白胆固醇（HDL-C）、Hb、TG、BMI、UA、HbA₁c、FPG、腰围、DBP、SBP预测NAFLD的受试者工作特征（ROC）曲线下面积（AUC）分别为：0.556、0.515、0.456、0.397、0.647、0.667、0.356、0.629、0.693、0.749、0.577、0.664、0.636、0.730、0.612。腰围、BMI均对NAFLD有较好的预测价值。结论 NAFLD组痰湿质、湿热质高于对照组，湿热质、痰湿质、腰围、FPG、Hb、UA、GGT、ALT、TG、HbA₁c、BMI、DBP、SBP会对NAFLD产生显著的正向影响，腰围、BMI均对NAFLD有较好的预测价值。更多还原

【Abstract】 Objective To investigate the predictive value of traditional Chinese medicine（TCM） constitution identification and risk factors for senile nonalcoholic fatty liver disease（NAFLD）.Methods This was a cross-sectional survey involving 835 participants aged 60 to 91 years old. The data of all the participants, including age, gender, past history, height, weight, waist circumference（WC）, blood pressure, biochemical indicators, B-ultrasound examination were collected. An analysis of TCM constitution identification was conducted, and the participants were divided into control group and NAFLD group according to the results of B-ultrasound, and the relevant data was analyzed. Results The participants with phlegm dampness（19.46% [72/370] vs 8.39% [39/465], P< 0.001） and damp-heat constitution（5.41% [20/370] vs 2.37% [11/465], P<0.05） in the NAFLD group were significantly higher than those in the control group. Phlegm-dampness constitution, damp-heat constitution, WC, fasting blood glucose（FPG）, hemoglobin（Hb）, uric acid（UA）, gamma-glutamyltransferase（GGT）, alanine aminotransferase（ALT）, triglyceride（TG）, glycated hemoglobin（HbA₁c）, body mass index（BMI）, diastolic blood pressure（DBP）, systolic blood pressure（SBP） had a significant positive effect on NAFLD（P< 0.05）, and the regression coefficients were 0.970, 0.858, 0.097, 0.274, 0.033, 0.003, 0.016, 0.057, 0.976, 0.545, 0.333, 0.033, 0.008, respectively. The area under the receiver operating characteristic（ROC） curve（AUC） for predicting NAFLD by phlegm-dampness constitution, damp-heat constitution, yang-deficiency constitution, age, GGT, ALT, high-density lipoprotein cholesterol（HDL-C）, Hb, TG, BMI, UA, HbA₁c, FPG, WC, DBP and SBP were: 0.556, 0.515, 0.456, 0.397, 0.647, 0.667, 0.356, 0.629, 0.693, 0.749, 0.577, 0.664, 0.636, 0.730, 0.612. Both WC and BMI had better predictive values for NAFLD. Conclusion The NAFLD patients present significantly higher phlegm-dampness constitution and damp-heat constitution relative to the controls. Phlegm-dampness constitution, damp-heat constitution, WC, FPG, Hb, UA, GGT, ALT, TG, HbA₁c, BMI, DBP and SBP have significant positive effects on NAFLD. Both WC and BMI have better predictive values for NAFLD.更多还原