CAJ | 학술논문

目的探讨超声测定的肝脏脂肪含量与颈动脉内膜中层厚度(C-IMT)的关系.方法选取2009年12月至2010年6月上海肥胖研究(SHOS)中单个社区人群1217人,筛选具备完整临床资料以及超声测定的肝脏衰减系数与颈动脉内膜中层厚度的人群,以肝脏衰减系数半定量判定肝脏脂肪含量.按肝脏衰减系数三分位点分组比较研究对象的临床特点,分析C-IMT与各临床参数的相关性,并采用多元逐步回归分析影响C-IMT的危险因素.结果 (1)超声定性诊断无颈动脉斑块且无非酒精性脂肪性肝病(NAFLD)者505人,其中男225人,女280人,年龄34 ～ 66岁,平均(50±6)岁.与肝脏衰减系数下三位组相比,上三位组的年龄(t=-2.41,P＜0.05)、舒张压(DBP)显著升高(Z=-1.27,P＜0.05),腰围(W)、体质指数(BMI)显著降低(=3.95、6.17,均P＜0.05).(2) C-IMT水平随着肝脏衰减系数的升高而显著增加(F=13.83,P＜0.05),肝脏衰减系数上三分位组较下三位点组C-IMT增厚的频率显著升高(35.3％比23.2％,X2=6.19,P ＜0.05).(3)多元逐步回归分析显示除年龄、W、收缩压(SBP)、空腹血糖(FPG)、吸烟状态外,肝脏衰减系数是C-IMT的独立影响因素(β=0.03,P＜0.05).结论超声定性不能识别的NAFLD人群中肝脏脂肪含量与C-IMT密切相关,肝脏衰减系数对筛选代谢风险无显著升高人群的早期亚临床动脉粥样硬化有一定临床价值.
목적 탐토초성측정적간장지방함량여경동맥내막중층후도(C-IMT)적관계.방법 선취2009년12월지2010년6월상해비반연구(SHOS)중단개사구인군1217인,사선구비완정림상자료이급초성측정적간장쇠감계수여경동맥내막중층후도적인군,이간장쇠감계수반정량판정간장지방함량.안간장쇠감계수삼분위점분조비교연구대상적림상특점,분석C-IMT여각림상삼수적상관성,병채용다원축보회귀분석영향C-IMT적위험인소.결과 (1)초성정성진단무경동맥반괴차무비주정성지방성간병(NAFLD)자505인,기중남225인,녀280인,년령34 ～ 66세,평균(50±6)세.여간장쇠감계수하삼위조상비,상삼위조적년령(t=-2.41,P＜0.05)、서장압(DBP)현저승고(Z=-1.27,P＜0.05),요위(W)、체질지수(BMI)현저강저(=3.95、6.17,균P＜0.05).(2) C-IMT수평수착간장쇠감계수적승고이현저증가(F=13.83,P＜0.05),간장쇠감계수상삼분위조교하삼위점조C-IMT증후적빈솔현저승고(35.3％비23.2％,X2=6.19,P ＜0.05).(3)다원축보회귀분석현시제년령、W、수축압(SBP)、공복혈당(FPG)、흡연상태외,간장쇠감계수시C-IMT적독립영향인소(β=0.03,P＜0.05).결론 초성정성불능식별적NAFLD인군중간장지방함량여C-IMT밀절상관,간장쇠감계수대사선대사풍험무현저승고인군적조기아림상동맥죽양경화유일정림상개치.
Objective To explore the relationship between liver fat content and carotid intima media thickness (C-IMT) with ultrasound measurement.Methods 1217 subjects with complete data on physical examination,plasma glucose,blood pressure and lipid profile from a community of Shanghai Obesity Study (SHOS) between December 2009 and June 2010 were enrolled.All of them underwent carotid artery ultrasound scan and liver attenuation coefficient tested by ultrasonography to evaluate liver fat content.Subjects were grouped by tertile analysis of liver attenuation coefficient.The comparison of clinical indexes and C-IMT was conducted,using correlation analysis and multiple stepwise regression to explore the risk factors which affected C-IMT.Results (1) A total of 505 subjects (225 men and 280 women),who aged from 34 to 66 years old was diagnosed as non-Nonalcoholic fatty liver disease (NAFLD) without history of cardiovascular disease and non-carotid arterial plaque.Compared with those in the lowest tertile of liver attenuation coefficient,subjects in the highest group had significantly higher age (t =-2.41,P ＜ 0.05)and diastolic blood pressure (DBP) (Z =-1.27,P ＜ 0.05),and significantly lower waist circumference (W) (t =3.95,P ＜ 0.05) and body mass index (BMI) (t =6.17,P ＜ 0.05).(2) C-IMT significantly increased with the increment of liver attenuation coefficient (F =13.83,P ＜ 0.05).The frequency of C-IMT elevation was also significantly higher in the highest tertile group compared with the lowest one (35.3％ vs 23.2％,X2 =6.19,P ＜0.05).(3) Multiple stepwise regression analysis showed that liver attenuation coefficient was independent risk factor with C-IMT after adjustment of age,W,SBP fasting blood glucose (FBG) and smoking (β =0.03,P ＜ 0.05).Conclusion Liver attenuation coefficient measured by ultrasonography is an effective method to identify liver fat content,which is closely correlated with C-IMT among undiagnosed NAFLD subjects by ultrasonography and it shows a clinical significance for early screening of subclinical atherosclerosis even among low cardiometabolic risk subjects.