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目的:探讨血尿酸水平与非酒精性脂肪性肝病（NAFLD）患病的相关性。方法:构建中南大学湘雅医院职工体检队列，2012年2月1日至2013年1月29日期间，选取3 479例无NAFLD的医院职工作为研究对象，通过问卷调查、体格检查、腹部超声检查、血脂、血糖、肝肾功能等实验室检测收集基线资料。2013年2月1日至2018年12月31日间，每年体检时进行随访，共随访6年。以血尿酸水平作为观察指标并按照四分位数分为A、B、C、D四组，分别计算总体人群及不同性别四组间NAFLD累积发病率。以是否发生NAFLD作为结局指标，尿酸四组为观察指标，年龄、体质指数、高血脂、高血糖、高血压、肌酐、丙氨酸氨基转移酶作为混杂因素，构建4个Cox回归分析模型，探索不同血尿酸水平分组与NAFLD之间的关系。按性别进行分层，构建3个Cox回归分析模型，探讨不同性别间血尿酸水平分组与NAFLD之间的关系。结果:四组NAFLD 6年累积发病率分别为1.2%、3.1%、4.9%、12%（χn 2=114.710，n P<0.05），其中女性职工A、B、C、D四组6年累积发病率分别为1.0%、2.9%、4.1%、10.9%（χn 2=71.241，n P<0.05）。B、C、D三组的NAFLD的发病风险是A组的2.04（1.01~4.11）、2.24（1.13~4.44）、3.89（1.94~7.80）倍（均n P<0.05）；女性职工中，B、C、D三组的NAFLD的发病风险是A组的2.21（1.02~4.77）、2.39（1.10~5.19）、4.49（1.99~10.15）倍（均n P<0.05）。n 结论:随着血尿酸水平增高，体检人群NAFLD发病风险增高，这一趋势主要表现在女性中。“,”Objective:To investigate the correlation between serum uric acid level and non-alcoholic liver disease (NAFLD).Methods:A medical examination cohort of our hospital′s staff was constructed. From February 1, 2012 to January 29, 2013, a total of 3, 479 staff without NAFLD were selected as research subjects, and baseline data were collected through a questionnaire survey, physical examination, abdominal ultrasound examination, blood lipid, blood glucose, liver and kidney function, and other laboratory tests. From February 1, 2013 to December 31, 2018, the patients were followed up during the annual physical examination for six years. The serum uric acid level was used as the observation index and divided into four groups from A to D according to the quartile. With the occurrence of NAFLD as the outcome indicator; the four groups of uric acid as the observation indicator; and age, body mass index, hyperlipidemia, hyperglycemia, hypertension, creatinine, and alanine aminotrans ferase as confounding factors; four Cox regression analysis models were constructed to explore the relationship between groups of different blood uric acid levels and NAFLD. Stratified by gender, three Cox regression analysis models were constructed to investigate the relationship between blood uric acid level grouping and NAFLD between different genders.Results:The six-year cumulative incidence of NAFLD in groups A, B, C, and D was 1.2%, 3.1%, 4.9%, and 12%, respectively (χn 2=114.710, n P<0.05). Among the female workers, the six-year cumulative incidence rates in groups A, B, C, and D were 1.0%, 2.9%, 4.1% and 10.9%, respectively (χn 2=71.241, n P<0.05). The incidence risk of NAFLD in groups B, C, and D was 2.04 (1.01-4.11), 2.24 (1.13-4.44), and 3.89 (1.94-7.80) times that of group A,n P<0.05, respectively. The incidence risk of NAFLD in groups B, C, and D was 2.21 (1.02-4.77), 2.39 (1.10-5.19), and 4.49 (1.99-10.15) times that of group A, alln P<0.05, respectively.n Conclusion:The risk of NAFLD increased with the increase of serum uric acid level, and this trend was mainly manifested in female employees.