2961名在职医务人员脂肪肝患病调查及危险因素分析

肝脏 ›› 2021, Vol. 26 ›› Issue (10): 1157-1162.

2961名在职医务人员脂肪肝患病调查及危险因素分析

李晓鹤, 刘慧鑫, 陈红松, 饶慧瑛

100044 北京大学人民医院,北京大学肝病研究所,丙型肝炎和肝病免疫治疗北京市重点实验室,非酒精性脂肪性肝病诊断北京市国际科技合作基地

收稿日期:2021-03-11 出版日期:2021-10-31 发布日期:2021-12-07
通讯作者: 饶慧瑛,Email:rao.huiying@163.com;陈红松,Email:chenhongsong@pkuph.edu.cn
基金资助:
国家自然科学基金(81870406)

Investigation on the prevalence and risk factors of fatty liver disease in 2961 in-service medical staff

LI Xiao-he, LIU Hui-xin, CHEN Hong-song, RAO Hui-ying

Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis,Beijing 100044, China

Received:2021-03-11 Online:2021-10-31 Published:2021-12-07
Contact: RAO Hui-ying, Email:huiying@163.com, CHEN Hong-song, Email: chenhongsong@pkuph.edu.cn

摘要/Abstract

摘要： 目的了解在职医务人员的脂肪肝患病情况、分布特点及危险因素。方法以2019年7月至8月于北京某医院在职体检的医务人员为研究对象,收集年龄、性别、体质量指数(BMI)、血压、空腹血糖(FBG)、血脂、尿酸(UA)、肝功能、肝脏超声等体检结果。分析年龄、性别及代谢因素与脂肪肝患病关系,并分析脂肪肝患病影响因素。结果共纳入体检人员2961人,脂肪肝患病率为22.23%(661/2961)。男性患病率为48.09%(290/603),高于女性的15.73%(371/2357)(χ²=289.98,P<0.01)。20~29岁、30~39岁、40~49岁和≥50岁组男性脂肪肝患病率分别为34.5%(35/110)、46.9%(105/224)、55.1%(70/127)和56.3%(80/142)(χ²=202.30,P<0.01),各年龄组均高于同年龄组女性的5.5%(38/632)、12.0%(110/914)、21.7%(117/538) 和38.8%(106/273)(均P＜0.01)。在职医务人员中重度脂肪肝患病率为5%(148/2961),男性(12.11%,73/603)高于女性(3.18%,75/2357)(χ²=80.56,P＜0.01)。多因素logistic回归分析显示,年龄(OR 1.04,95%CI 1.03~1.05)、男性(OR 1.72,95%CI 1.34~2.22)、超重(OR 3.97, 95%CI 3.10~5.09)、FBG≥7.0 mmol/L(OR 3.23, 95%CI 1.69~6.15)、高尿酸(OR 2.20, 95%CI 1.71~2.83)、高血压(OR 1.58,95%CI 1.11~2.24)、高TG血症(OR 2.80,95%CI 2.18~3.59)、低HDL-c血症(OR 1.56,95%CI 1.10~2.18)、高LDL-c血症(OR 1.43,95%CI 1.11~1.84)为脂肪肝患病危险因素;对年龄进行分层后,超重/肥胖(OR 2.05~6.19)、高三酰甘油血症(OR 2.91~3.67)在各年龄层均为脂肪肝患病的危险因素;在20~29岁、30~39岁年龄组,高尿酸血症人群脂肪肝患病率为正常人群的7.28(95%CI 3.92~13.54)倍和2.01(95%CI 1.34~3.03)倍,均P＜0.01;在40~49岁、≥50岁人群,糖尿病人群脂肪肝患病风险是正常人群的5.3倍(95%CI 1.67~16.92)和2.95倍(95%CI 1.85~4.71)。结论在职医务人员群体脂肪肝患病率随年龄增长而增加,男性高于女性,超重/肥胖、高尿酸血症、糖代谢紊乱、高血压、血脂异常为脂肪肝的危险因素。

关键词: 脂肪肝, 在职医务人员, 健康体检, 危险因素

Abstract: Objective To investigate the prevalence, distribution and risk factors of fatty liver disease (FLD) of in-service medical staff. Methods A cross-sectional study was designed to collect the physical examination results of medical staff in a large general hospital in Beijing from July to August 2019. The relationship between age, gender, metabolic factors and FLD were analyzed. Univariate and multivariate logistic regression were used to analyze the influencing factors of FLD. Results Prevalence rate of FLD was 22.32 (661/2961), with 48.09% (290/603) in male and 15.73% (371/2357) in female(χ²=289.98,P<0.001). The prevalence rates of male aged 20-29, 30-39, 40-49 and ≥ 50 years old were 34.5%(35/110), 46.9%(105/224), 55.1% (70/127) and 56.3% (80/142), respectively (χ²=202.30, P<0.001), with significant higher incidence than women in each age group, 5.5% (38/632), 12.0% (110/914), 21.7% (117/538) and 38.8%(106/273), all P value＜0.001. The prevalence of moderate to severe FLD was about 5% (38/632), with male (12.11%, 73/603) more than female (3.18%, 75/2357) (χ²=80.56, P<0.001). Age, gender, overweight/ obesity, FBG ≥ 7.0 mmol/L, dyslipidemia, hypertension and hyperuricemia were all influential factors for FLD (all P<0.05). After stratification for age, overweight/obesity (OR 3.92-13.54) and hypertriglyceridemia (OR 2.91-3.67) were risk factors in all groups of age. Compared with normal level of uric acid populations, staffs with hyperuricemia were at an increased risk for FLD by 7.28 (95%CI: 3.92-13.54) fold and 2.01 (95%CI: 1.34-3.03) fold in group 20-29 and 30-39 years old,respectively. The risk increased about 4.3-and 2-fold in group of 40-49 and ≥50 years old (P<0.01) due to diabetes. Conclusion The prevalence of FLD in serving medical staffs in Beijing was increased with age, and men tend to have a higher prevalence rate than women. Overweight/obesity, hyperuricemia, abnormal glucose metabolism, hypertension and dyslipidemia were major causes of FLD.

Key words: Fatty liver disease, Serving medical staffs, Physical examination, Risk factors

李晓鹤, 刘慧鑫, 陈红松, 饶慧瑛. 2961名在职医务人员脂肪肝患病调查及危险因素分析[J]. 肝脏, 2021, 26(10): 1157-1162.

LI Xiao-he, LIU Hui-xin, CHEN Hong-song, RAO Hui-ying. Investigation on the prevalence and risk factors of fatty liver disease in 2961 in-service medical staff[J]. Chinese Hepatolgy, 2021, 26(10): 1157-1162.

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