An analysis of fatty liver and related factors of middle-aged and elderly people from a HBV infection cohort in Qidong area
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摘要:
目的 探讨乙型肝炎病毒（hepatitis B virus，HBV）慢性感染合并脂肪肝的关联因素，为HBV合并脂肪肝的防治提供依据。 方法 选择2019年6月启东市HBV感染队列随访人群，收集相关病史信息，采用B超检测脂肪肝，用多因素Logistic回归分析模型分析合并脂肪肝的关联因素。 结果 该队列人群年龄（63.22±7.84）岁，脂肪肝患病率为30.18%（909/3 012）；患病率女性高于男性（33.94%>27.25%，χ2=15.767，P < 0.001）。患病率在各年龄组差异有统计学意义（χ2=11.614，P=0.003），以60~70岁年龄组最高。肝纤维化患者中脂肪肝的检出率为62.50%（205/328）。多因素Logistic回归分析模型分析显示，高血压、糖尿病、高血脂病史、烟酒嗜好以及肥胖是脂肪肝的主要危险因素（均有P < 0.001）。 结论 启东地区中老年HBV感染人群脂肪肝的患病率较高，且女性高于男性，并随年龄增长而降低。体重、血压、血脂及肝纤维化等也是脂肪肝不可忽视的危险因素，应当加以重视。 Abstract:Objective To investigate the related factors of chronic hepatitis B virus (HBV) infection with fatty liver disease(FLD), in order to provide a basis for prevention and treatment. Methods The HBV infection cohort in Qidong City was followed up in June 2019 to collect relevant medical history information. FLD was detected by B-ultrasound and the related factors were analyzed by multivariate Logistic regression model. Results The age of the cohort was (63.22±7.84) years old, and the prevalence of FLD was 30.18% (909/3 012). The prevalance rate of FLD was higher in female than in male (33.94%>27.25%, χ2=15.767, P < 0.001), and with statistical difference among age groups (χ2=11.614, P=0.003), being the highest in the 60-70 age group. The detection rate of fatty liver in patieuts with hepatic fibrosis was 62.50% (205/328). Multivariate Logistic regression analysis showed that history of hypertension, diabetes, hyperlipidemia, as well as tobacco or alcohol preferences and obesity were main risk factors for FLD (all P < 0.001). Conclusion The FLD prevalence of the middle-aged and elderly individuals in the HBV-infected cohort in Qidong is high, especially in women and 60-70 age group. Body weight, blood pressure, blood lipid and liver fibrosis are also the risk factors of FLD, which should be paid attention to. -
Key words:
- HBV /
- Fatty liver disease /
- Factor analysis /
- Prevalence
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表 1 脂肪肝与非脂肪肝组一般情况单因素分析
Table 1. Univariate analysis of general conditions of fatty liver group and non-fatty liver group
变量 脂肪肝(n=909) 非脂肪肝(n=2 103) χ2值 P值 例数(例) 构成比(%) 例数(例) 构成比(%) 性别 15.767 < 0.001 男 461 50.72 1 231 58.54 女 448 49.28 872 41.46 年龄(岁) 11.614 0.003 < 60 341 37.52 726 34.52 60~ 400 44.00 870 41.37 ≥70 168 18.48 507 24.11 BMI指数 421.435 < 0.001 偏瘦 12 1.33 114 5.42 正常 227 24.97 1 117 53.12 偏胖 397 43.67 743 35.33 肥胖 273 30.03 129 6.13 谷丙转氨酶(U/L) 17.684 < 0.001 ≥40 60 6.60 68 3.23 < 40 849 93.40 2 035 96.77 
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表 2 脂肪肝与非脂肪肝组既往病史单因素分析
Table 2. Univariate analysis of previous medical history of fatty liver group and non-fatty liver group
变量 脂肪肝(n=909) 非脂肪肝(n=2 103) χ2值 P值 例数(例) 构成比(%) 例数(例) 构成比(%) 高血压 305.692 < 0.001 有 457 50.28 399 18.97 无 452 49.72 1 704 81.03 糖尿病 102.833 < 0.001 有 157 17.27 119 5.66 无 752 82.73 1 984 94.34 高血脂 97.716 < 0.001 有 106 11.66 58 2.76 无 803 88.34 2 045 97.24 吸烟史 43.902 < 0.001 不吸烟 504 55.45 1 410 67.05 轻度 73 8.03 133 6.32 中度 167 18.37 234 11.13 重度 165 18.15 326 15.50 饮酒史 131.400 < 0.001 有 530 58.31 753 35.81 无 379 41.69 1 350 64.19 肝纤维化 182.480 < 0.001 有 205 22.55 123 5.85 无 704 77.45 1 980 94.15
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表 3 HBV慢性感染合并脂肪肝的关联因素Logistic回归分析模型分析
Table 3. Logistic regression analysis of related factors of chronic HBV infection with fatty liver
变量 β值 Sx值 Wald值 P值 OR(95% CI)值 性别 男 1.000 女 0.501 0.096 27.428 < 0.001 1.650(1.368~1.990) 年龄(岁) < 60 0.420 0.126 11.164 0.001 1.522(1.190~1.947) 60~ 0.529 0.131 16.394 < 0.001 1.696(1.313~2.191) ≥70 1.000 BMI指数 正常 1.000 偏瘦 -0.439 0.320 1.879 0.170 0.645(0.344~1.208) 偏胖 0.969 0.104 86.685 < 0.001 2.635(2.149~3.231) 肥胖 2.236 0.141 251.029 < 0.001 9.353(7.093~12.333) 高血压病史 无 1.000 有 1.213 0.100 146.531 < 0.001 3.363(2.763~4.092) 糖尿病病史 1.000 有 0.651 0.159 16.710 < 0.001 1.917(1.403~2.620) 高血脂病史 无 1.000 有 0.759 0.201 14.212 < 0.001 2.136(1.440~3.170) 谷丙转氨酶(U/L) < 40 1.000 ≥40 0.499 0.220 5.164 0.023 1.648(1.071~2.535) 吸烟史 无 1.000 有 0.099 0.039 6.349 0.012 1.104(1.022~1.192) 饮酒史 无 1.000 有 0.617 0.095 42.407 < 0.001 1.853(1.539~2.231) 常量 -3.589 0.205 305.575 < 0.001 0.028
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