| 王优一,赵琦,陈波,王娜,张铁军,姜永根,吴毅凌,何纳,赵根明,刘星.上海市社区居民代谢相关慢性病组合与非酒精性脂肪肝患病关联分析[J].中华流行病学杂志,2023,44(7):1106-1113 |
| 上海市社区居民代谢相关慢性病组合与非酒精性脂肪肝患病关联分析 |
| Association between metabolism-related chronic disease combination and prevalence of non-alcoholic fatty liver disease in community residents in Shanghai |
| 收稿日期:2023-01-06 出版日期:2023-07-15 |
| DOI：10.3760/cma.j.cn112338-20230106-00012 |
| 中文关键词: 非酒精性脂肪肝 代谢相关慢性病 |
| 英文关键词: Non-alcoholic fatty liver disease Metabolism-related chronic disease |
| 基金项目:国家重点研发计划精准医学研究重点专项（2017YFC0907000，2017YFC0908001）；上海市加强公共卫生体系建设三年行动计划（2020-2022年）；上海地方高水平学科建设项目 |
| 作者 | 单位 | E-mail | | 王优一 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | | | 赵琦 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | | | 陈波 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | | | 王娜 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | | | 张铁军 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | | | 姜永根 | 上海市松江区疾病预防控制中心, 上海 201620 | | | 吴毅凌 | 上海市松江区疾病预防控制中心, 上海 201620 | | | 何纳 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | | | 赵根明 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | | | 刘星 | 复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室, 上海 200032 | liuxing@fudan.edu.cn |
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| 中文摘要: |
| 目的 了解上海市社区居民与非酒精性脂肪肝（NAFLD）患病率相关的代谢性慢性病组合。方法 使用上海郊区自然人群队列和生物样本库基线数据，根据问卷调查、体格检查及血生化检测获得肥胖、高血压、高脂血症、痛风及糖尿病5种代谢相关慢性病患病情况，根据B超及问卷调查诊断NAFLD，运用多因素logistic回归模型分析合并不同数量及类型的31种代谢相关慢性病组合与NAFLD患病的关联。结果 65 477名研究对象年龄M（Q1，Q3）为60（51，66）岁，男性占40.6%。NAFLD总患病率为38.2%，无5种代谢相关慢性病中任1种者NAFLD患病率为12.0%。总人群（OR=37.94，95%CI：31.02~46.41）、女性（OR=36.99，95%CI：28.78~47.54）及≥60岁组（OR=36.19，95%CI：28.25~46.36）与NAFLD患病关联最强的慢性病组合均为肥胖+高血压+高脂血症+痛风+糖尿病，男性（OR=50.70，95%CI：24.62~104.40）及<60岁组（OR=49.58，95%CI：24.22~101.47）与NAFLD患病关联最强的组合为肥胖+高脂血症+痛风+糖尿病。结论 上海市社区居民NAFLD患病率较高，需重点关注肥胖人群且倡导减重，对合并痛风、糖尿病、高脂血症、高血压者加强社区健康教育，及时纠正血尿酸、血糖、血脂、血压等指标的异常，以降低NAFLD的风险。 |
| 英文摘要: |
| Objective To explore the combination of metabolism-related chronic diseases associated with the prevalence of non-alcoholic fatty liver disease (NAFLD) in community residents in Shanghai. Methods The baseline data of Shanghai Suburban Adult Cohort and Biobank were used to understand the prevalence of five metabolism-related chronic diseases, including obesity, hypertension, hyperlipidemia, gout and diabetes, based on questionnaire survey, physical examination and blood biochemical detection. NAFLD was diagnosed by B-ultrasound detection and questionnaire. Multivariable logistic regression model was used to analyze the association of 31 metabolism-related chronic diseases combinations with the prevalence of NAFLD. Results The median age (Q1, Q3) of 65 477 subjects was 60 (51, 66) years, and men accounted for 40.6%. The overall prevalence of NAFLD was 38.2%, and the prevalence of HAFLD in patients without any of the five metabolism-related chronic diseases was 12.0%. The chronic disease combination with the strongest association with NAFLD was obesity + hypertension + hyperlipidemia + gout + diabetes in the total population (OR=37.94, 95%CI:31.02-46.41), in women (OR=36.99, 95%CI:28.78-47.54) and in age group ≥ 60 years (OR=36.19, 95%CI:28.25-46.36). The chronic disease combination with the strongest association with NAFLD was obesity + hyperlipidemia + gout + diabetes in men (OR=50.70, 95%CI:24.62-104.40) and in age group <60 years (OR=49.58, 95%CI:24.22-101.47).Conclusions The prevalence of NAFLD in community residents in Shanghai was high. Attention needs to be paid to health of obese people and weight loss should be promoted for them. Community health education should be strengthened for patients complicated with gout, diabetes, hyperlipidemia and hypertension and it is necessary to correct abnormal serum uric acid, blood sugar, blood lipids and blood pressure in a timely manner to reduce the risk of NAFLD. |
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