天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (12): 1304-1307.doi: 10.11958/20180780

• 临床研究 • 上一篇    下一篇

成年人群中糖化血红蛋白和非酒精性脂肪肝的关系

郭奕瑞，刘颖，杨艳，张莉   

  1. 天津市第一中心医院健康体检科（邮编300192）
  • 收稿日期:2018-05-14 修回日期:2018-08-31 出版日期:2018-12-15 发布日期:2019-01-24
  • 通讯作者: 张莉 E-mail:13752299379@163.com

Association between glycosylated hemoglobin and non-alcoholic fatty liver disease in adults

GUO Yi-rui,LIU Ying,YANG Yan,ZHANG Li   

  1. Department of Physical Examination, Tianjin First Central Hospital, Tianjin 300192, China
  • Received:2018-05-14 Revised:2018-08-31 Published:2018-12-15 Online:2019-01-24

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摘要： 目的 评估成年人群中糖化血红蛋白（HbA1c）与非酒精性脂肪肝（NAFLD）之间的关系。方法 本研究以天津市第一中心医院健康体检科招募2017年健康体检者11 943例为研究对象，包括体格检查和血液生化指标检测。采用2010年全国人口年龄构成作为标准人口进行年龄患病率标化，计算不同年龄、性别间NAFLD患病率的差异。应用Logistic回归模型评估HbA1c与NAFLD之间的关系。结果 NAFLD患病率为49.44%，标化患病率为40.46%。HbA1c≥6.5%组NAFLD 患病率（75.60%）高于6.0%≤HbA1c＜6.5%组（69.35%）和HbA1c＜6.0%组（44.60%），差异有 统计学意义（P＜0.05）。70岁以下人群中，NAFLD患病率随着HbA1c的升高而增加（P＜0.05）。在校正年龄、性别、体质量指数等混杂因素后，与 Quartile1 组（HbA1c＜5.2%）相比，Quartile3 组（5.5%≤HbA1c＜5.8%），Quartile4 组（HbA1c≥5.8%）发生NAFLD的风险值OR（95%CI）分别为1.41（1.220~1.631）和2.003（1.714~2.342）。在HbA1c＜6.0%人群中，与Q1组（HbA1c＜5.2%）相比，Q3组（5.4%≤HbA1c＜5.6%）、Q4组（5.6%≤HbA1c＜6.0%）发生NAFLD的风险值 OR（95%CI）分别为 1.267（1.087~1.477）和 1.557（1.339~1.811）。结论 在成年人群中 HbA1c 水平升高是发生NAFLD的独立危险因素。

关键词: 脂肪肝, 血红蛋白A, 糖基化, 横断面研究, 非酒精性脂肪肝, 糖化血红蛋白

Abstract: Objective To investigate the association between glycosylated haemoglobin (HbA1c) and nonalcoholic fatty liver disease (NAFLD) in adults. Methods A total of 11 943 subjects were selected from the health examination adults in Tianjin First Central Hospital from January to December 2017. Data included physical examination and blood biochemical index detection. The differences of NAFLD prevalence between age and gender were calculated using the age composition of the national population in 2010 as the standard population. One-way ANOVA was applied to the comparison of multiple groups, and the comparison of the rate was carried out by chi-square test. Logistic regression model was used to assess the relationship between HbA1c and NAFLD. Results A total of 5 651 (49.44%) subjects fulfilled the diagnostic criteria of NAFLD, and the standardized prevalence of NAFLD was 40.46%. The prevalence of NAFLD was significantly higher in subjects with serum HbA1c level (HbA1c≥6.5%) than those with serum HbA1c level (6.0%≤HbA1c＜6.5%) and serum HbA1c level (HbA1c＜6.0%) (75.60% vs. 69.35% vs. 44.60%, P ＜0.05). The prevalence of NAFLD increased with the progressively higher serum HbA1c levels in subjects under 70 years old (P＜0.05). Stepwise logistic regression analysis showed that the risk factors for NAFLD were increased in the subjects of Quartile 3 (5.5%≤HbA1c＜5.8%) (odds ratio 1.41,95% confidence interval 1.220-1.631) and Quartile 4 (HbA1c≥5.8%) (odds ratio 2.003, 95% confidence interval 1.714-2.342) as compared with the subjects of Quartile1(HbA1c＜5.2%) after adjusting for the related factors including age, gender and body mass index. Among the population with HbA1c＜6.0%, the risk factors for NAFLD were increased in the subjects of Q3 (5.4%≤HbA1c＜5.6%) (odds ratio 1.267,95% confidence interval 1.087,1.477) and Q4 (5.6%≤HbA1c＜6.0%) (odds ratio 1.557, 95% confidence interval 1.339-1.811) as compared with the subjects of Q1(HbA1c＜5.2%). Conclusion The elevated levels of HbA1c in adults are independent risk factors of NAFLD.

Key words: Nonalcoholic fatty liver disease, Glycosylated hemoglobin, Physical examination