非肥胖人群的腰围轨迹与新发非酒精性脂肪肝的相关性

王珊; 张健; 蒋晓忠; 佟博; 王谦; 张卫欢; 杨艳英; 夏建新; 吴寿岭

Abstract

王珊,张健,蒋晓忠,佟博,王谦,张卫欢,杨艳英,夏建新,吴寿岭.非肥胖人群的腰围轨迹与新发非酒精性脂肪肝的相关性[J].Chinese journal of Epidemiology,2020,41(6):824-828

非肥胖人群的腰围轨迹与新发非酒精性脂肪肝的相关性

Relationship between waist circumference trajectory and new-onset non alcoholic fatty liver disease in the non-obese population

Received:June 30, 2019

DOI：10.3760/cma.j.cn112338-20190630-00479

KeyWord: 非酒精性脂肪肝腰围轨迹队列研究

English Key Word: Nonalcoholic fatty liver disease Waist circumference trajectory Cohort study

FundProject:

Author Name	Affiliation	E-mail
Wang Shan	Kailuan General Hospital, Tangshan 063000, China
Zhang Jian	Kailuan General Hospital, Tangshan 063000, China
Jiang Xiaozhong	Kailuan General Hospital, Tangshan 063000, China
Tong Bo	Kailuan General Hospital, Tangshan 063000, China
Wang Qian	Kailuan General Hospital, Tangshan 063000, China
Zhang Weihuan	Kailuan General Hospital, Tangshan 063000, China
Yang Yanying	Kailuan General Hospital, Tangshan 063000, China
Xia Jianxin	Kailuan General Hospital, Tangshan 063000, China
Wu Shouling	Kailuan General Hospital, Tangshan 063000, China	drwusl@163.com

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Abstract:

目的探讨非肥胖人群的腰围轨迹与新发非酒精性脂肪肝（NAFLD）的相关性。方法以开滦研究中符合入选标准的观察对象组成研究队列，依据观察对象2006-2007、2008-2009、2010-2011年健康体检的腰围数值，使用SAS Proc Traj程序确定4个不同的腰围轨迹组，分别为低、中、中高、高稳定组，随访各组2012-2013、2014-2015、2016-2017年健康体检时NAFLD的发病情况，比较各组NAFLD的累积发病率，用Cox比例风险回归模型分析不同腰围轨迹与新发NAFLD的相关性。结果最终纳入统计分析者共12 477例，其中男性8 181例，女性4 296例。腰围低、中、中高、高稳定组分别为1 026例（8.2%）、5 183例（41.5%）、5 481例（44.0%）、787例（6.3%），随访期间共发生NAFLD 4 123例。NAFLD的累积发病率随着腰围轨迹的升高而增加（分别为21%、43%、59%、72%），差异有统计学意义（P<0.01）。腰围中、中高、高稳定组NAFLD发病风险分别为腰围低稳定组的2.411（95% CI：2.021～2.877）、4.050（95% CI：3.402～4.820）、5.489（95% CI：4.506～6.686）倍（P<0.01）；采用Cox比例风险回归模型校正年龄、性别等多种混杂因素后，腰围中、中高、高稳定组NAFLD发病风险仍为腰围低稳定组的2.150（95% CI：1.789～2.582）、3.176（95% CI：2.623～3.846）、3.732（95% CI：2.987～4.662）倍。结论非肥胖人群发生NAFLD的风险随着腰围轨迹的升高而增加，高水平的腰围轨迹是NAFLD发病的独立危险因素。

English Abstract:

Objective To investigate the relationship between waist circumference trajectory and new-onset nonalcoholic fatty liver disease (NAFLD) in the non-obese population. Methods The study cohort was composed of the ones who met the selection criteria in Kailuan study. Waist circumference trajectories of the participants in 2006-2007, 2008-2009 and 2010-2011 were determined by SAS Proc Traj program. Four groups with different waist circumference trajectories were generated, including low-, medium-, medium-high- and high-stability groups. All groups were followed up for their health conditions in 2012-2013, 2014-2015 and 2016-2017, respectively. Incidence rates of NAFLD during physical examination were compared among different waist circumference trajectory groups. Cox regression model was used to analyze the correlation between different waist circumference trajectory groups and new-onset NAFLD. Results Finally, 12 477 observers were included in the statistical analysis, including 8 181 males and 4 296 females. There were 1 026 (8.2%), 5 183 (41.5%), 5 481 (44.0%) and 787 cases (6.3%) in the low, medium, medium-high and high stability-stability groups, respectively. There were 4 123 NAFLD cases occurred during the follow-up period. The cumulative incidence of NAFLD increased along with the increase of waist circumference trajectory (21%, 43%, 59%, 72%, respectively) (P<0.01). The risks of NAFLD were 2.411 (95%CI: 2.021-2.877), 4.050 (95%CI: 3.402-4.820) and 5.489 (95%CI: 4.506-6.686) times higher in medium-, medium- high- and high-stability group than that in the low-stability group (P<0.01). After adjusting for age, sex and other confounding factors, the risks of NAFLD in the medium-, medium-high- and high- stability groups were 2.150 (95%CI: 1.789-2.582), 3.176 (95%CI: 2.623-3.846) and 3.732 (95%CI: 2.987-4.662) times higher than that in the low-stability group. Conclusion The risk of NAFLD in non-obese people increased along with the increase of waist circumference trajectory, which seemed to have played an independent risk factor for NAFLD.

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