中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
7期
2852-2855
,共4页
皇甫竞坤%闫杰%王艳斌%谢雯
皇甫競坤%閆傑%王豔斌%謝雯
황보경곤%염걸%왕염빈%사문
脂肪肝%脂联素%人体质量指数%稳态模型胰岛素抵抗指数
脂肪肝%脂聯素%人體質量指數%穩態模型胰島素牴抗指數
지방간%지련소%인체질량지수%은태모형이도소저항지수
Fatty liver%Adiponectin%Body mass index%HOMA-IR
目的研究北京市成人非酒精性脂肪肝( NAFLD)患者血清脂联素水平的变化特点并对其相关因素进行分析。方法通过随机多级分层整群抽样对2007~2008年北京市东城区和通州区各4个居委会20岁以上居民进行流行病学调查,按照随机配对的原则,排除其中有高血压、糖尿病、肝硬化的患者。入选NAFLD组435例,平均年龄(45.0±11.4)岁,对照组442例,平均年龄(44.7±11.6)岁,测量受试者的身高、体重、腰围及臀围;抽空腹血测定肝肾功能、肝炎病毒标志物、空腹血糖( FBG)、血脂、空腹胰岛素( FINS)和脂联素;计算体重指数(BMI)及稳态模型胰岛素抵抗指数(HOMA-IR)。采用SPSS 19.0软件进行统计学分析。计量资料采用t检验,脂联素相关因素分析采用Spearman等级相关分析,以P<0.05为差异有统计学意义,NAFLD的危险因素用多因素非条件Logistic回归分析。结果(1) NAFLD组体重指数、腰臀比、血压、血糖、血清总胆固醇、甘油三酯、胰岛素水平、低密度脂蛋白胆固醇、HOMA-IR、尿酸较非NAFLD组高( P均<0.05),而脂联素、高密度脂蛋白胆固醇( HDL-C)则较对照组低( P均<0.05)。(2)血清脂联素与BMI、HO-MA-IR、腰臀比、血糖、TG、TC、低密度脂蛋白胆固醇( LDL-C )、尿酸呈负相关( r值分别为-0.075,-0.13,-0.185,-0.49,-0.137,-0.008,-0.041,-0.133,P均<0.05)。(3)采用多因素非条件Logistic回归分析,入选变量包括:腰臀比、BMI、收缩压、舒张压、甘油三酯、LDL-C、HDL-C、尿酸、ALT、血糖、FINS、HOMA-IR、脂联素。结果显示 BMI、HOMA-IR、脂联素是 NAFLD 形成的主要危险因素,回归方程 P =1/[1+e-(-8.734+0.281BMI+0.409HOMA-IR-0.198脂联素)]。结论 NAFLD患者的特征是体重增加,存在明显胰岛素抵抗,脂联素含量减少。其中血清脂联素水平的下降与NAFLD的发生存在密切的关系。
目的研究北京市成人非酒精性脂肪肝( NAFLD)患者血清脂聯素水平的變化特點併對其相關因素進行分析。方法通過隨機多級分層整群抽樣對2007~2008年北京市東城區和通州區各4箇居委會20歲以上居民進行流行病學調查,按照隨機配對的原則,排除其中有高血壓、糖尿病、肝硬化的患者。入選NAFLD組435例,平均年齡(45.0±11.4)歲,對照組442例,平均年齡(44.7±11.6)歲,測量受試者的身高、體重、腰圍及臀圍;抽空腹血測定肝腎功能、肝炎病毒標誌物、空腹血糖( FBG)、血脂、空腹胰島素( FINS)和脂聯素;計算體重指數(BMI)及穩態模型胰島素牴抗指數(HOMA-IR)。採用SPSS 19.0軟件進行統計學分析。計量資料採用t檢驗,脂聯素相關因素分析採用Spearman等級相關分析,以P<0.05為差異有統計學意義,NAFLD的危險因素用多因素非條件Logistic迴歸分析。結果(1) NAFLD組體重指數、腰臀比、血壓、血糖、血清總膽固醇、甘油三酯、胰島素水平、低密度脂蛋白膽固醇、HOMA-IR、尿痠較非NAFLD組高( P均<0.05),而脂聯素、高密度脂蛋白膽固醇( HDL-C)則較對照組低( P均<0.05)。(2)血清脂聯素與BMI、HO-MA-IR、腰臀比、血糖、TG、TC、低密度脂蛋白膽固醇( LDL-C )、尿痠呈負相關( r值分彆為-0.075,-0.13,-0.185,-0.49,-0.137,-0.008,-0.041,-0.133,P均<0.05)。(3)採用多因素非條件Logistic迴歸分析,入選變量包括:腰臀比、BMI、收縮壓、舒張壓、甘油三酯、LDL-C、HDL-C、尿痠、ALT、血糖、FINS、HOMA-IR、脂聯素。結果顯示 BMI、HOMA-IR、脂聯素是 NAFLD 形成的主要危險因素,迴歸方程 P =1/[1+e-(-8.734+0.281BMI+0.409HOMA-IR-0.198脂聯素)]。結論 NAFLD患者的特徵是體重增加,存在明顯胰島素牴抗,脂聯素含量減少。其中血清脂聯素水平的下降與NAFLD的髮生存在密切的關繫。
목적연구북경시성인비주정성지방간( NAFLD)환자혈청지련소수평적변화특점병대기상관인소진행분석。방법통과수궤다급분층정군추양대2007~2008년북경시동성구화통주구각4개거위회20세이상거민진행류행병학조사,안조수궤배대적원칙,배제기중유고혈압、당뇨병、간경화적환자。입선NAFLD조435례,평균년령(45.0±11.4)세,대조조442례,평균년령(44.7±11.6)세,측량수시자적신고、체중、요위급둔위;추공복혈측정간신공능、간염병독표지물、공복혈당( FBG)、혈지、공복이도소( FINS)화지련소;계산체중지수(BMI)급은태모형이도소저항지수(HOMA-IR)。채용SPSS 19.0연건진행통계학분석。계량자료채용t검험,지련소상관인소분석채용Spearman등급상관분석,이P<0.05위차이유통계학의의,NAFLD적위험인소용다인소비조건Logistic회귀분석。결과(1) NAFLD조체중지수、요둔비、혈압、혈당、혈청총담고순、감유삼지、이도소수평、저밀도지단백담고순、HOMA-IR、뇨산교비NAFLD조고( P균<0.05),이지련소、고밀도지단백담고순( HDL-C)칙교대조조저( P균<0.05)。(2)혈청지련소여BMI、HO-MA-IR、요둔비、혈당、TG、TC、저밀도지단백담고순( LDL-C )、뇨산정부상관( r치분별위-0.075,-0.13,-0.185,-0.49,-0.137,-0.008,-0.041,-0.133,P균<0.05)。(3)채용다인소비조건Logistic회귀분석,입선변량포괄:요둔비、BMI、수축압、서장압、감유삼지、LDL-C、HDL-C、뇨산、ALT、혈당、FINS、HOMA-IR、지련소。결과현시 BMI、HOMA-IR、지련소시 NAFLD 형성적주요위험인소,회귀방정 P =1/[1+e-(-8.734+0.281BMI+0.409HOMA-IR-0.198지련소)]。결론 NAFLD환자적특정시체중증가,존재명현이도소저항,지련소함량감소。기중혈청지련소수평적하강여NAFLD적발생존재밀절적관계。
Objective To investigate the relationship between serum adiponectin and nonalcoholic fatty liver disease in Beijing .Methods Across-sectional survey with multiple-stages stratified cluster and random sampling was performed .All residents aged 20 and above were invited to participate in the survey;they came from two communities of Dongcheng District and Tongzhou District .435 cases with NAFLD were collected ,442 cases without fatty liver were selected randomly as control .The associated variables were analyzed by using logistic regression model .The clinical data and liver function were compared between two groups .Results (1) The BMI,WHR,BP,FPG,TC,TG,FINS, LDL-C,HOMAIR,UA in the NAFLD were higher than in the control (P<0.05),the serum adiponectin and HDL-C in the NAFLD were lower than in the control ( P<0.05 ) .( 2 ) The serum level was negatively correlated with BMI , HOMA-IR,WHR,FPG,TG,TC,LDL and UA(r:-0.075,-0.13,-0.185,-0.49,-0.137,-0.008,-0.041,-0.133,P<0.05).(3) The linear multiple regression analysis showed that NAFLD were significantly positively correlated with BMI,HOMA-IR and adiponectin.P=1/[1+e-( -8.734+0.281BMI+0.409HOMA-IR-0.198 adiponectin) ].Conclusions These data indicate that NAFLD patients manifest higher BMI ,obviously insulin resistance ,low serum adiponecin , and suggest that adiponectin may play a crucial role in the pathogenesis of NAFLD .