肝脏 ›› 2024, Vol. 29 ›› Issue (8): 980-984.

• 非酒精性脂肪性肝病 • 上一篇    下一篇

生活方式对瘦型非酒精性脂肪性肝病患者的影响

袁乙富, 杜晟楠, 何诗嘉, 曹勤, 华红梅, 蒋元烨   

  1. 200062 上海中医药大学附属普陀医院消化内科(袁乙富,杜晟楠,何诗嘉,曹勤,蒋元烨);200333 上海市白玉社区卫生服务中心(华红梅)
  • 收稿日期:2023-08-08 出版日期:2024-08-31 发布日期:2024-09-30
  • 通讯作者: 华红梅,Email:hongmeihua1983@163.com;蒋元烨,Email:yuanye1014@126.com
  • 基金资助:
    上海市自然科学基金(22ZR1455900);上海市普陀区卫生健康系统科技创新项目重点项目(ptkwws202201);上海市普陀区杏林优青人才培养计划(ptxlyq2201);上海市普陀区卫生健康系统特色专病建设项目(2023tszb01)

Impact of lifestyle factors on lean non-alcoholic fatty liver disease patients

YUAN Yi-fu1, DU Sheng-nan1, HE Shi-jia1, Cao Qin1, HUA Hong-mei2, JIANG Yuan-ye1   

  1. 1. Department of Gastroenterology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China;
    2. Shanghai Baiyu Community Health Service Center, Shanghai 200333, China
  • Received:2023-08-08 Online:2024-08-31 Published:2024-09-30
  • Contact: HUA Hong-mei,Email:hongmeihua1983@163.com;JIANG Yuan-ye,Email:yuanye1014@126.com

摘要: 目的 探讨不同程度瘦型非酒精性脂肪性肝病(NAFLD)患者的生活方式特征及其危险因素。方法 选取2019年12月—2021年12月在上海市普陀区中心医院消化内科门诊、住院部以及上海市白玉社区卫生服务中心就诊的瘦型NAFLD患者336例进行问卷调查,收集其一般情况、运动习惯、饮食习惯等数据,并根据B超结果将其分为轻度、中度和重度三组。运用描述性统计、卡方检验、有序logistic回归等方法进行数据分析。结果 瘦型NAFLD患者以女性居多,年龄主要集中在44~59岁之间,不同程度瘦型NAFLD患者在运动习惯、运动时间、体力活动水平差异有统计学意义(χ2=38.381;χ2=142.618;χ2=228.488;P<0.001)。不同程度瘦型NAFLD患者饮食习惯中喜生冷食物、喜水果素食、喜含糖饮料差异有统计学意义(χ2=9.007;χ2=7.631;χ2=6.207;P<0.05)。有序logistic回归表明,一周运动1~2 d(OR=0.382, P<0.01)、体力活动水平理想(OR=0.268, P<0.01)是瘦型NAFLD患者B超分级程度进展发生的保护因素;而喜嗜肉类(OR=2.677, P<0.001)、喜含糖饮料(OR=1.330, P<0.05)是瘦型NAFLD患者B超分级程度进展的独立危险因素。结论 规律适量的运动是瘦型NAFLD患者病情进展的保护因素,喜嗜肉类和含糖饮料是瘦型NAFLD患者病情进展的独立危险因素。

关键词: 瘦型NAFLD, 生活方式, 超声分级

Abstract: Objective To investigate the lifestyle characteristics of lean non-alcoholic fatty liver disease (NAFLD) patients and their association with the severity of ultrasound grading. Methods A total of 336 patients with lean NAFLD who attended the outpatient and inpatient departments of the gastroenterology department at Shanghai Putuo District Central Hospital and Shanghai Baiyu Community Health Service Center from December 2019 to December 2021 were selected for a questionnaire survey. Data on general conditions, exercise habits, dietary habits, and other lifestyle factors were collected. Patients were categorized into three groups- mild, moderate, and severe-based on ultrasound results. Descriptive statistics, chi-square test, and ordered logistic regression were utilized to analyze the data. Results Lean NAFLD patients were predominantly female, with ages primarily ranging from 44 to 59 years. Statistically significant differences were observed among patients with varying degrees of lean NAFLD concerning exercise habits, exercise duration, and physical activity levels(χ2=38.381; χ2=142.618; χ2=228.488; P<0.001). Differences in dietary habits were also significant, with preferences for raw and cold foods,fruits and vegetables, and sugary drinks among patients with different degress of leanness(χ2=9.007; χ2=7.631; χ2=6.207; P<0.05). Ordered logistic regression analysis revealed that exercising 1-2 days per week (OR=0.382, P<0.01) and maintaining an ideal physical activity level (OR=0.268, P<0.01) were protective factors against the progression of ultrasound grading severity in lean NAFLD patients. Conversely, a preference for meat (OR=2.677, P<0.001) and sugary beverages (OR=1.330, P<0.05) were identified as independent risk factors for the progression of ultrasound grading severity in these patients. Conclusion Regular and moderate exercise is a protective factor against the progression of lean NAFLD while consumption of meat and sugary drinks are independent risk factors for disease progression in lean NAFLD patients.

Key words: Lean NADLD, Lifestyle, Degree of ultrasound grading