Analysis of risk factors for liver fibrosis and fatty liver in the population undergoing physical examination in Chibi City
赤壁市体检人群肝纤维化和脂肪肝危险因素分析

摘要

目的 选取赤壁市肝纤维化和脂肪肝早期筛查的体检人群，通过对体检和生活方式数据的分析，探索体检人群中肝纤维化和脂肪肝的危险因素，为早期预防肝纤维化和脂肪肝提供依据。方法 对1443名体检人群进行问卷调查和相关指标检查。问卷调查：主要调查体检人群的人口学情况（如年龄、性别）、行为生活方式（如饮食习惯、体育锻炼情况、吸烟饮酒情况、既往病史）。相关指标检查：主要测量体质指数、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白及肝脏硬度和脂肪衰减等指标。对肝纤维化程度和脂肪肝程度进行相关性分析、危险因素分析以及预测模型。结果 单因素分析中性别（男性）、年龄、体质指数、甘油三酯、吸烟、饮酒、高血压、糖尿病、血脂异常与肝纤维化有统计学意义（P＜0.05）。其中，体质指数与不同程度的肝纤维具有显著差异。性别、年龄、体质指数、总胆固醇、甘油三酯、低密度脂蛋白、食物油腻、吸烟、饮酒高血压、糖尿病、血脂异常与脂肪肝有统计学意义（P＜0.05）。其中，体质指数和甘油三酯与不同程度的脂肪肝具有显著差异。多因素Logistic回归分析结果显示，男性（OR=1.798，OR95%CI=1.175-2.752）、年龄（OR=1.041，OR95%CI=1.028-1.054）、体质指数升高（OR=1.329，OR95%CI=1.264-1.399）、糖尿病（OR=1.822，OR95%CI=1.034-3.211）为肝纤维化的独立危险因素。男性（OR=2.201，OR 95%CI=1.467-3.303）、年龄（OR=1.013，OR95%CI=1.001-1.025）、体质指数升高（OR=1.518，OR 95%CI=1.476-1.693）、甘油三酯异常（OR=1.874，OR95%CI=1.528-2.288）为脂肪肝的独立危险因素。多因素模型对患者是否肝纤维化异常和脂肪肝异常进行预测效果都较好。结论 男性、年龄、肥胖、糖尿病为肝纤维化的独立危险因素。男性、年龄、肥胖、甘油三酯异常为脂肪肝的独立危险因素。

Abstract

Objective We select the physical examination population for early screening of liver fibrosis and fatty liver in Chibi City, and explore the risk factors of liver fibrosis and fatty liver in the physical examination population through analysis of physical examination data and behavioral lifestyle data, in order to provide a basis for health departments and governments to prevent liver fibrosis and fatty liver.
Methods A questionnaire survey and related index examinations were conducted on 1443 physical examination population. Questionnaire survey: mainly investigate the demography (such as age and gender), behavior and lifestyle (such as dietary habits, physical exercise, smoking and drinking habits, and past medical history) of the physical examination population. Observation indicators: Body mass index (height and weight), total cholesterol, triglyceride, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), and other indicators about liver stiffness, and liver fat attenuation were mainly measured. Correlation analysis, risk factor analysis, and prediction models are performed on the degree of liver fibrosis and fatty liver.
Results Univariate analysis showed that gender (male), age, body mass index, triglyceride, exercise, smoking, drinking, hypertension, diabetes, dyslipidemia were statistically significant in relation to liver fibrosis (P<0.05). Among them, body mass index showed significant differences in different degrees of liver fibrosis. Gender, age, body mass index, total cholesterol, triglycerides, low-density lipoprotein (LDL-C), oily food, smoking, drinking, hypertension, diabetes, and dyslipidemia were statistically significant for fatty liver (P<0.05). Among them, body mass index and triglycerides have significant differences with different degrees of fatty liver. Multiple logistic regression analysis showed that male (OR=1.798, OR95%CI=1.175-2.752), age (OR=1.041, OR95%CI=1.028-1.054), increased body mass index (OR=1.329, OR95%CI=1.264-1.399) were independent risk factors for liver fibrosis. Male (OR=2.201, OR95%CI=1.467-3.303), age (OR=1.013, OR95%CI=1.001-1.025), increased body mass index (OR=1.518, OR95%CI=1.476-1.693), abnormal triglycerides (OR=1.874, OR95%CI=1.528-2.288) were independent risk factors for fatty liver. The multivariable models showed good predictive performance for both liver fibrosis and fatty liver abnormalities in patients.
Conclusion   Male, age, obesity and diabetes were independent risk factors for liver fibrosis. Male, age, obesity and abnormal triglycerides were independent risk factors for fatty liver.