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目的探讨北京地区成年人不同性别中血尿酸(UA)与非酒精性脂肪肝(NAFLD)的相关性。方法回顾性调查2010年1～10月在笔者医院接受健康体检的人员,共计2074例(男性1447例,女性627例)。脂肪肝采用B型超声进行检测。代谢综合征(MS)诊断标准采用美国国家胆固醇教育计划成人治疗方案第3次报告(NCEP-ATPⅢ)的中国人修订标准。结果男、女性NAFLD患病率分别为28.1%和21.9%(P<0.01)。按UA水平四分位数分组(Q1～Q4组)显示,随UA分组水平升高,男、女性NAFLD患病率皆呈趋势性升高。控制年龄和各种肝酶后,经多元Logistic回归分析显示,男性UA水平Q4较Q1发生NAFLD的OR(95%CI)值是1.57(1.10～2.22)倍;女性是3.96(1.92～8.14)倍;同时控制年龄、AST、ALT、GGT和MS等因素后,男性UA不再是NAFLD的独立危险因素(P>0.05),而女性UA依然是NAFLD的危险因素(P=0.001)。结论男、女性UA与NAFLD皆具有显著相关性。男性UA与NAFLD的相关性受到MS的影响,女性UA与NAFLD的相关性独立于MS。
Objective To investigate the correlation between serum UA and non-alcoholic fatty liver (NAFLD) in adults of different genders in Beijing. Methods A total of 2074 cases (1447 males and 627 females) were recruited in our hospital from January to October in 2010. Fatty liver using B-mode ultrasound detection. Metabolic syndrome (MS) diagnostic criteria using the United States National Cholesterol Education Program Adult Treatment Program Third Report (NCEP-ATP Ⅲ) Chinese revised standards. Results The prevalence of NAFLD in male and female was 28.1% and 21.9%, respectively (P <0.01). According to the UA level quartiles (Q1 ~ Q4 group) showed that with the UA group level increased, male and female NAFLD prevalence showed a trend of rising. After controlling for age and various liver enzymes, multivariate Logistic regression analysis showed that OR (95% CI) of male with UA level Q4 compared with Q1 was 1.57 (1.10-2.22) times and that of female was 3.96 (1.92- 8.14) times UA was no longer an independent risk factor for NAFLD (P> 0.05), while female UA was still a risk factor for NAFLD (P = 0.001) after controlling for age, AST, ALT, GGT and MS. Conclusion Male and female UA and NAFLD have significant correlation. The association of male UA with NAFLD is influenced by MS, and the association of female UA with NAFLD is independent of MS.