男性嗜酒者中脂肪肝的存在同样预示更高的代谢异常患病率

肝脏 ›› 2020, Vol. 25 ›› Issue (12): 1309-1312.

男性嗜酒者中脂肪肝的存在同样预示更高的代谢异常患病率

季蕾, 范建高, 李锋

200032 上海交通大学附属第一人民医院护理部(季蕾);上海交通大学附属新华医院消化科(范建高);复旦大学附属中山医院消化科(李锋)

收稿日期:2020-09-20 出版日期:2020-12-31 发布日期:2021-02-26
通讯作者: 李锋,Email:li.feng2@zs-hospital.sh.cn
基金资助:
国家自然科学基金(81670513),上海市青年科技启明星计划(13QA1400700),上海市卫生系统优秀青年医学人才培养计划(XYQ2013089)。

The occurrence of fatty liver in males with excessive alcohol intake indicates higher prevalence of metabolic abnormalities

JI Lei, FAN Jian-gao, LI Feng

Department of Gastroenterology, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China

Received:2020-09-20 Online:2020-12-31 Published:2021-02-26
Contact: LI Feng,Email:li.feng2@zs-hospital.sh.cn

摘要/Abstract

摘要： 目的观察嗜酒者中脂肪肝与代谢异常患病的关系。方法 2001年1月至2002年12月在上海宝钢集团股份有限公司体检中心参加体检的14 578位职工中,根据定义识别男性嗜酒者,观察该人群脂肪肝和代谢异常患病的关系。结果共有男性嗜酒者2 792人,其中474人(17.0%)患有脂肪肝。伴有脂肪肝者的体重指数为(26.98±2.46) kg/m²、收缩压(129.87±15.38) mmHg、舒张压(88.69±9.77) mmHg、甘油三酯(2.46±1.90) mmol/L、总胆固醇(5.51±0.96) mmol/L和空腹血糖(6.05±1.22) mmol/L明显均高于无脂肪肝者(23.70±2.69) kg/m²、(121.06±14.56) mmHg、(82.28±9.86) mmHg、(1.52±1.38) mmol/L、(4.95±0.91) mmol/L、(5.54±0.97) mmol/L(均P<0.001)。与无脂肪肝者相比,伴有脂肪肝者有更高的代谢异常包括肥胖(80.0%比30.8%)、高血压(60.8%比30.6%)、高三酰甘油血症(61.8%比25.9%)、高总胆固醇血症(42.2%比19.4%)和糖尿病(18.8%比8.1%)的患病率(均P<0.05)。多变量Logistic分析发现,高三酰甘油血症(P<0.001)、高总胆固醇血症(P=0.044)和糖尿病(P=0.004)是嗜酒者合并脂肪肝的影响因素。结论在男性嗜酒者中,脂肪肝不仅仅是酒精性肝损伤的表现,它的存在也提示更高的代谢异常发生率。

关键词: 嗜酒, 脂肪肝, 代谢异常, 患病率

Abstract: Objective To investigate the relationship between fatty liver and metabolic abnormalities in subjects with excessive alcohol intake.Methods Among the employees of the Bao-Steel Group (Shanghai, China), males with excessive alcohol intake were identified, and their medical records from check-ups were analyzed. The association between fatty liver and the prevalence of metabolic abnormalities was assessed among them.Results Two thousand seven hundred and ninety-two males with excessive alcohol intake were identified, and the prevalence of fatty liver was 17.0%. The average levels of body mass index (26.98 ±2.46 kg/m² vs. 23.70 ± 2.69 kg/m²), systolic blood pressure (129.87 ± 15.38 mmHg vs. 121.06±14.56 mmHg), diastolic blood pressure (88.69±9.77 mmHg vs. 82.28 ± 9.86 mmHg), serum triglycerides (2.46 ± 1.90 mmol/L vs. 1.52 ± 1.38 mmol/L), total cholesterol (5.51±0.96 mmol/L vs. 4.95 ± 0.91 mmol/L) and fasting glucose (6.05±1.22 mmol/L vs. 5.54 ± 0.97 mmol/L) were all significantly higher in the individuals with fatty liver than those without (all P<0.001). The prevalence of metabolic abnormalities including obesity (80.0% vs. 30.8%), hypertension (60.8% vs. 30.6%), hypertriglyceridemia (61.8% vs. 25.9%), hypercholesterolemia (42.2% vs. 19.4%) and diabetes mellitus (18.8% vs. 8.1%) were all higher in the individuals with fatty liver (all P<0.05). Even in non-obese individuals, fatty liver was still significantly associated with higher prevalence of hypertriglyceridemia (P<0.001), hypercholesterolemia (P=0.044) and diabetes mellitus (P=0.004).Conclusion In men with excessive alcohol intake, fatty liver is not merely a manifestation of alcoholic liver injury, but an indicator for a higher prevalence of metabolic abnormalities. Thus, in this population, those with fatty liver should be paid more attention to the identification and treatment of the related metabolic abnormalities.

Key words: Excessive alcohol intake, Fatty liver, Metabolic abnormality, Prevalence

季蕾, 范建高, 李锋. 男性嗜酒者中脂肪肝的存在同样预示更高的代谢异常患病率[J]. 肝脏, 2020, 25(12): 1309-1312.

JI Lei, FAN Jian-gao, LI Feng. The occurrence of fatty liver in males with excessive alcohol intake indicates higher prevalence of metabolic abnormalities[J]. Chinese Hepatolgy, 2020, 25(12): 1309-1312.

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