摘要
目的 研究广东省普通人群非酒精性脂肪性肝病（NAFLD）患病率、发病率、死亡原因、自然史以及NAFLD发病的危险因素。方法在2005年3543例普通人群NAFLD流行病学调查的基础上进行随访调查（中位随访时间4年），对全部人群进行死亡原因调查，并对其中624例愿意接受复查者（复查组）再次进行问卷调查、体检、血生化和B超检查，分析NAFLD的自然病程和发病的危险因素。结果全部3543例中，失访219例，基线时NAFLD患者可随访467例，其中4例（8．6％）死亡，均死于心脑血管疾病；原未患NAFLD者可随访2857例，其中22例（7．7‰）死亡，死因主要是心脑血管疾病及恶性肿瘤，两者差异无统计学意义（P〉0．05）。复查组（624例）中基线时患NAFLD者117例，其中51例（43．6％）终点时病变程度不变，26例（22．2％）加重，21例（18．0%）减轻，19例（16．2％）消退；基线时未患NAFLD的507例中，新发NAFLD185例（36．5％）。标化患病率2005年为10．5%，至2009年为22．6％，上升显著（P〈0．05）。标化年发病率为4．9％[男性（5．1％）高于女性（4．7％），P〈0．05]。城市累积发病率（43．1％）高于农村（27．4％，P〈0．05）。单因素Cox比例风险回归分析显示：NAFLD发病与年龄（OR=1．893，P〈0．05）、腰围（OR=2．512．P〈0．05）、腰臀比（OR=1．400，P〈0．05）、体重指数（BMI，OR=2．581，P〈0．05）、血胆固醇水平（OR=1．587，P〈0．05）相关。多因素分析显示：BMI和年龄为相关因素。腰围较小的患者NAFLD更易消退。结论广东省普通人群NAFLD的患病率和发病率高，NAFLD死因以心脑血管疾病为主，而非肝病。肥胖、年龄大和血脂紊乱是NAFLD发病的高危因素。
Objective To investigate the prevalence, incidence, death causes and natural course of nonalcoholic fatty liver disease （NAFLD） as well as the risk factors of NAFLD development in population of Guangdong province. Methods On the basis of previous epidemiological survey in 2005, 3545 subjects were followed up （medium 4 years） for death causes. Of which, 624 subjects （reurvey group） received interview, physical examinations, biochemical tests and uitrasonography again. The natural course and the risk factors of the NAFLD were analyzed. Results Of 3543 subjects, 219 subjects were failed to followed up and 4 out of 467 NAFLD patients （8.6‰） died of cardiovascular and cerebrovascular diseases during follow-up period. In rest 2857 subjects, 22 （7. 7‰） died of cardiovascular/eerebrovascular diseases and cancers. However, there were 117 NAFLD patients in resurvey group at the baseline. The NAFLD remained in 51 （43. 6‰） patients, aggravated in 26 （22.2%）, alleviated in 21 （18.0%） and regressed in 19 （16. 2%） at the endpoint. Meanwhile 185 （36.5%） out of 507 normal subjects developed NAFLD at the endpoint. The standard prevalence of NAFLD increased from 10. 5% （2005） to 22. 6% （2009, P〈0. 05）. The standard incidence was 4.9% per year with male （5. 1%） being higher than female （4. 7%,P〈0. 05）. The cumulative incidence was significantly higher in urban cities （43. 1%） than in rural areas （27.4%, P〈0.05）. Cox proportional hazards regression showed that the age （OR 1. 893）, waist circumference （OR= 2. 512）, waist-to hip ratio （WHR, OR= 1. 400）, body mass index （BMI, OR= 2. 581） and serum cholesterol levels （OR=1. 587） were associated with the development of NAFLD （P〈0. 05）. Multivariate regression logistic analysis revealed that age and BMI were associated factors for NAFLD. Decreased waist circumference was prone to remission. Conclusions The higher prevalence and incidence of NAFLD were noted in population of Guangdong province. The NAFLD patients mainly died of cardiovascular/eerebrovascular diseases, but not liver disease. Obesity, aging and dyslipidemia are high risk factors for NAFLD development.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2010年第8期512-517,共6页
Chinese Journal of Digestion
基金
广州市卫生重大科技项目（2008-Zdi-1）
关键词
非酒精性脂肪性肝病
流行病学
自然史
发病率
危险因素
Nonalcoholic fatty liver disease
Epidemiology
Natural history
Incidence
Risk factors
