体检人群非酒精性脂肪性肝病与心血管疾病发病风险的关联性研究

doi:10.3969/j.issn.1006-5253.2022.02.001

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摘要目的了解咸阳市体检人群非酒精性脂肪性肝病（NAFLD）的流行现况，分析NAFLD与心血管疾病发病风险的关系，为NAFLD人群心血管疾病的预防提供依据和建议。方法选择2019年咸阳市中心医院健康管理中心受检者15 766例，收集血压、身高、体质量、血糖、血脂等信息，利用超声诊断脂肪肝，采用《中国心血管病预防指南（2017）》中动脉硬化性心血管病（ASCVD）的10年发病风险评估方法估计该体检人群未来10年的ASCVD发病风险，运用多元logistic回归分析NAFLD与未来10年ASCVD发病风险的关系。结果体检人群NAFLD的患病率为38.3%，男性（43.8%）高于女性（29.6%），且NAFLD的患病率存在年龄差异（χ²=272.57，P<0.001）。未来10年ASCVD发病风险等级极高危者占2.0%，高危占14.3%，中危占13.4%，低危占70.3%。在控制年龄、性别、糖尿病、高血压、超重或肥胖、血脂异常和吸烟混杂因素后，与非NAFLD人群相比，NAFLD人群未来10年ASCVD发病风险增加31%（OR＝1.31，95%CI：1.12~1.52），男女性人群中其OR值分别为1.35（95%CI：1.12~1.61）和1.20（95%CI：0.86~1.68）。排除极高危人群后，NAFLD与心血管疾病发病风险的关系仍保持不变。结论咸阳市体检人群NAFLD的患病率较高，NAFLD可增加未来10年ASCVD的发病风险，建议对NAFLD体检人群，尤其是男性，开展心血管疾病发病风险评估，以减缓控制心血管疾病的进展。

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关键词 ：非酒精性脂肪性肝病, 动脉粥样硬化性心血管病, 风险评估, 体检人群

Abstract：Objective To study the prevalence of nonalcoholic fatty liver disease (NAFLD) among physical examination population in Xianyang City, and to analyze the relationship between NAFLD and risk of cardiovascular diseases, so as to provide basis and suggestions for the prevention of cardiovascular diseases in population with NAFLD.Methods Totally 15 766 subjects were selected from the Health Management Center of Xianyang Central Hospital in 2019. Blood pressure, height, weight, blood glucose, blood lipid and other indices were collected to diagnose fatty liver by ultrasound. The 10 year risk assessment method of atherosclerotic cardiovascular disease (ASCVD) provided by the Guidelines for the Prevention of Cardiovascular Diseases in China (2017) was used to estimate the risk of ASCVD in the examined population in the next 10 years. Multiple logistic regression analysis was used to analyze the relationship between NAFLD and the risk of ASCVD in the next 10 years.Results The overall prevalence of NAFLD was 38.3%, men had a higher prevalence than women (43.8% vs 29.6%) , and the prevalence of NAFLD was different in age groups (χ²=272.57, P<0.001). The risk of ASCVD in the next 10 years showed that the extremely high-risk was 2.0%, the high risk was 14.3%, the intermediate risk was 13.4% and the low risk was 70.3%. After controlling for age, sex, diabetes, hypertension, overweight or obesity, dyslipidemia and smoking confounding factors, compared with non NAFLD population, the risk of ASCVD in NAFLD population in the next 10 years increased by 31% (or = 1.31, 95%ci: 1.12~1.52), and the or values in male and female population were 1.35 (95%ci:1.12~1.61) and 1.20 (95%ci:0.86~1.68) respectively. The relationship between NAFLD and the risk of cardiovascular disease remained unchanged after excluding extremely high-risk groups. Conclusion The prevalence of NAFLD is high among the physical examination population in Xianyang city. NAFLD can increase the risk of ASCVD in the next 10 years. It is suggested that the risk assessment of cardiovascular disease should be carried out among the physical examination population of NAFLD, especially men, in order to slow down the progress of cardiovascular disease control.

Key words： non-alcoholic fatty liver disease atherosclerotic cardiovascular disease risk assessment physical examination population

收稿日期: 2022-01-25

基金资助:基金项目：陕西省自然科学基础研究计划（2021JM-034）

通讯作者: 党少农，Email：tjdshn@mail.xjtu.edu.cn

引用本文:

水明明，石明，李艳萍，张晨，党少农. 体检人群非酒精性脂肪性肝病与心血管疾病发病风险的关联性研究[J]. 中国医院统计, 2022, 29(2): 81-86.
Shui Mingming，Shi Ming， Li Yanping，Zhang Chen，Dang Shaonong. Association between non-alcoholic fatty liver disease and risk of cardiovascular diseases in physical examination population. journal1, 2022, 29(2): 81-86.

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