常州市大学生代谢相关性脂肪性肝病的流行特点

摘要/Abstract

摘要： 目的了解常州市大学生代谢相关性脂肪性肝病(MAFLD)的流行情况和特点。方法采用肝脏受控衰减参数(CAP值)和肝脏超声作为MAFLD的诊断标准,对常州市3所大学的308名在校大学生进行脂肪肝的流行情况调查。比较分析MAFLD组与非MAFLD组在人体成分、血压、肝功能、血糖、血脂、尿酸、胰岛素抵抗指数(HOMA-IR)、血常规、饮食营养风险评分(DST scores)、最大摄氧量(VO₂Max)方面的差异。采用二元logistic,回归分析体重指数(BMI)、HOMA-IR、饮食营养风险、心肺适能对MAFLD的影响。结果以CAP值和肝脏超声作为诊断标准,MAFLD的发生率分为31.2%和20.6%。MAFLD组的BMI, 收缩压、舒张压、ALT、γ-谷氨酰基转移酶(GGT)、三酰甘油(TG)、低密度脂蛋白(LDL)、HOMA-IR、白细胞计数、红细胞计数、血小板计数均高于非MAFLD组,BMI为26.85 (24.8,28.5)kg/m²比20.7(18.9,22.08)kg/m²、收缩压为120(113,128)mmHg比110 (100,120)mmHg、舒张压为(76.88 ± 7.60) mmHg比(72.06 ± 8.33)mmHg、ALT为20 (10,42) U/L比11 (9,14) U/L、GGT为 23 (17,29) U/L比15 (11,18) U/L、TG为 0.92 (0.69,1.51) U/L比0.71 (0.56,0.9) U/L、LDL为(2.79±0.61) mmol/L比(2.41±0.67) mmol/L、HOMA-IR 为 1.59 (1.37,3.05)比1.14 (0.81,1.48),白细胞计数为(7.64±1.59)×10⁹比(6.23±1.28)×10⁹、红细胞计数为(5.21±0.53)×10¹²比(4.90±0.49)×10¹²、血小板计数为(284.00±42.73)×10⁹比(247.11±48.83)×10⁹。高密度脂蛋白(HDL)、DST scores、VO₂Max均低于非NAFLD组(P<0.05),HDL为(1.21±0.25)mmol/L比(1.45±0.33)mmol/L、DST scores为55.57±12.47 比60.94±9.67 、VO₂Max为37 (32.75,42.01)比40.71 (37.21,49.17)。BMI≥28 kg/m²、HOMA-IR≥1.5、饮食营养有风险、心肺适能较差分别增加MAFLD的患病风险22.5倍、5.1倍、15.3倍、3.3倍。结论大学生的MAFLD流行率高并伴有代谢综合征相关指标的变化应引起足够重视,应降低饮食营养风险、加强锻炼、控制体质量。

关键词: 代谢相关性脂肪性肝病, 脂肪肝, 代谢综合征, 流行

Abstract: Objective We sought to investigate the prevalence and characteristics of MAFLD and the influencing factor on the occurrence of MAFLD in 308 Changzhou college students. Methods We used a cross-sectional study design to investigate the occurrence of MAFLD in 308 college students and to establish the differences in parameters between MAFLD students and non-MAFLD students. Binary logistic regression analysis was used to assess the influence of body mass index (BMI), homeostatic model assessment of insulin resistance (HOMA-IR), cardiopulmonary fitness, and dietary risk on the occurrence of MAFLD. Results Using the controlled attenuation parameters (CAP) of liver and ultrasonic as diagnostic criteria, MAFLD occurred in 31.2% and 20.6% of participants. BMI, systolic blood pressure, diastolic blood pressure, alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), triglyceride (TG), low-density lipoprotein (LDL), HOMA-IR, white blood cell count (WBC), red blood cell count(RBC), and platelet count (PLT) of MAFLD students were higher than those of non-MAFLD students, BMI was 26.85 (24.8-28.5) vs 20.7 (18.9-22.08), systolic blood pressure was 120 (113-128) vs 110 (100-120), diastolic blood pressure was 76.88±7.60 vs 72.06±8.33, ALT was 20 (10-42) vs 11 (9-14), GGT was 23 (17-29) vs 15 (11-18), TG was 0.92 (0.69-1.51) vs 0.71 (0.56-0.9), LDL was (2.79±0.61) vs (2.41±0.67), HOMA-IR was 1.59 (1.37-3.05) vs1.14 (0.81-1.48), WBC was(7.64±1.59)vs (6.23±1.28), RBC was (5.21±0.53) vs (4.90±0.49), PLT was (284.00±42.73) vs (247.11±48.83). While dietary screening tool (DST) scores, VO₂Max, and high-density lipoprotein (HDL) were lower than those of non-MAFLD students (P<0.05), HDL was (1.21±0.25) vs (1.45±0.33), DST score was (55.57±12.47) vs (60.94±9.67), VO₂Max was 37 (32.75-42.01) vs 40.71 (37.21-49.17). BMI ≥ 28, HOMA-IR ≥ 1.5, nutritional in risk and poor cardiopulmonary fitness increased the risk for MAFLD (OR=22.5, 5.1, 15.3, 3.3, P<0.05). Conclusion MAFLD in college students requires attention and early intervention.

Key words: Metabolic-associated fatty liver disease (MAFLD), Fatty liver, Cardio-metabolic disease, Prevalence

孙青, 叶春艳, 陈清华, 朱琰, 曹喜霞, 赵丹洁, 付文育, 查晨林, 柳龙根, 张凡. 常州市大学生代谢相关性脂肪性肝病的流行特点[J]. 肝脏, 2021, 26(12): 1396-1400.

SUN Qing, YE Chun-yan, CHEN Qing-hua, ZHU Yan, CHAO Xi-xia, ZHAO Dan-jie, FU Wen-yu, ZHA Chen-lin. Prevalence and characteristics of metabolic-associated fatty liver disease in Changzhou college students[J]. Chinese Hepatolgy, 2021, 26(12): 1396-1400.

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