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中华诊断学电子杂志 ›› 2013, Vol. 01 ›› Issue (01) : 47 -50. doi: 10.3877/cma.j.issn.2095-655X.2013.01.010

所属专题： 总编推荐； 文献；

临床研究

健康体检人群体重指数与血脂水平及非酒精性脂肪肝关系的研究
邢燕1, 叶山东1,†(), 洪海鸥1, 陈燕1   
  1. 1. 230001　合肥，安徽省立医院内分泌科　健康体检中心
  • 收稿日期:2013-10-20 出版日期:2013-11-26
  • 通信作者: 叶山东
  • 基金资助:
    安徽省年度重点科研基金(11070403035)

The relationship between body mass index, lipid profile and non-alcoholic fatty liver disease in healthy check-up crowd

Yan Xing1, Shandong Ye1,†(), Haiou Hong1, Yan Chen1   

  1. 1. Department of Endocrinology, Anhui Provincial Hospital, Hefei 230001, China
  • Received:2013-10-20 Published:2013-11-26
  • Corresponding author: Shandong Ye
  • About author:
    Corresponding author: Ye Shandong, Email:
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邢燕, 叶山东, 洪海鸥, 陈燕. 健康体检人群体重指数与血脂水平及非酒精性脂肪肝关系的研究[J]. 中华诊断学电子杂志, 2013, 01(01): 47-50.

Yan Xing, Shandong Ye, Haiou Hong, Yan Chen. The relationship between body mass index, lipid profile and non-alcoholic fatty liver disease in healthy check-up crowd[J]. Chinese Journal of Diagnostics(Electronic Edition), 2013, 01(01): 47-50.

目的

探讨体重指数与血脂水平及非酒精性脂肪肝(non-alcoholic fatty liver disease, NAFLD)的关系。

方法

对2012年1月至2013年1月于安徽省立医院参加健康体检，病史及饮酒史资料完整的10000名体检者的人体质量指数(BMI)与其相关临床指标进行统计分析。按照BMI将人群分组，不同体重指数人群间血脂水平及NAFLD检出率差异采用χ2检验。

结果

(1)所有体检人群中超重及肥胖者5996例，占60%，正常体重者3829例，占38.3%；(2)超重和肥胖在不同年龄组人群中的构成比差异有统计学意义(χ2＝161.733，P＝0.000；(3)除高密度脂蛋白(HDL-C)外，超重组和肥胖组的甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)水平均明显高于体重正常组；(4)NAFLD和高脂血症的发生率随BMI水平升高而逐渐增加；(5)性别(男性)、BMI、TG、TC为NAFLD发生的独立危险因素，HDL-C为保护因素；(6)ROC曲线分析BMI预测NAFLD发生的最佳切点为(男性：24.85或24.95；女性24.95)。

结论

超重及肥胖是发生NAFLD和高脂血症的危险因素，应加强对体重的干预，以改善脂代谢和降低NAFLD的发生。

关键词: 肥胖, 超重, 人体质量指数, 血脂异常, 非酒精性脂肪肝
Objective

To analyze the relationship between body mass index, lipid profile and non-alcoholic fatty liver disease (NAFLD).

Methods

A population-based, cross-sectional study was carried out in 10 000 clients of health examination in the population of Hefei area in 2012. Body mass index (BMI), history of alcohol intake and past medical history were recorded. Subjects were divided into four groups according to the levels of BMI, clinical indicators included serum lipids, and fasting blood glucose and the rate of non-alcoholic fatty liver disease were compared among the four groups. Distribution of BMI of the masses in Hefei region was analyzed. The relationships between BMI and the incidences of hyperlipidemia and non-alcoholic fatty liver disease were discussed.

Results

(1)The occurring rate of obesity and overweight was 60%, normal weight was 38.3%. (2)The incidence of overweight and obesity was distinct in different age groups (χ2=161.733, P=0.000). (3)Except for high density lipoprotein-cholesterol, indicators included triglyceride, total cholesterol, low density lipoprotein-cholesterol, fasting blood sugar and uric acid levels in overweight and obesity groups were significantly higher than those in normal group. (4)With the increasing of BMI, the incidence of non-alcoholic fatty liver disease and hyperlipidemia were increased. (5)Factors including BMI, gender (male), triglyceride, total cholesterol were independent risk for non-alcoholic fatty liver disease, whereas high density lipoprotein cholesterol was a protective factor. (6)ROC analysis demonstrated that the best cut off value of BMI in predicting the incidence of non-alcoholic fatty liver disease was 24.85 or 24.95 in male and 24.95 in female.

Conclusions

Overweight and obesity are the risk factors for the prevalence of NAFLD and hyperlipidemia. Management of weight and targeted interventions rectifying the metabolism disorders at the earliest opportunity, which may contribute to reduce the risk of hyperlipidemia and NAFLD.

Key words: Obesity, Overweight body, Body mass index, Dyslipidemia, Non-alcoholic fatty liver disease
表1 不同年龄组健康体检者体重指数(BMI)分布情况比较
年龄组(岁) 人数 BMI<24.0 BMI≥24.0
例数 百分比(%) 例数 百分比(%)
<30 987 517 52.4 470 47.6
30 2372 936 39.5 1436 60.5
40 3390 1149 33.9 2241 66.1
50 1758 699 39.8 1059 60.2
60 924 400 43.3 524 56.7
>70 569 303 53.8 266 46.2
χ2值 ? 0.640
P值 ? 0.424
表2 健康体检人群不同人体质量指数(BMI)组血脂水平比较(中位数)
组别 例数 TC(mmol/L) TG(mmol/L) HDL-C(mmol/L) LDL-C(mmol/L)
BMI<18.5 175 4.5(3.93～5.11) 0.84(0.64～1.10) 1.51(1.26～1.77) 0.49(0.40～0.60)
18.5≤BMI≤23.9 3829 4.82(4.23～5.43) 1.2(0.85～1.75) 1.3(1.12～1.51) 0.55(0.44～0.68)
24≤BMI≤27.9 4538 4.99(4.45～5.59) 1.72(1.18～2.51) 1.16(1.01～1.35) 0.64(0.51～0.81)
BMI≥28 1458 5.05(4.5～5.68) 2.07(1.43～2.96) 1.09(0.95～1.26) 0.69(0.55～0.91)
χ2值 ? 168.452 1276.661 688.087 884.757
P值 ? 0.000 0.000 0.000 0.000
表3 健康体检人群不同人体质量指数(BMI)组高脂血症和非酒精性脂肪肝(NAFLD)发生率比较
组别 总例数 高TG血症 高TC血症 混合型高脂血症 NAFLD
例数 百分率(%) 例数 百分率(%) 例数 百分率(%) 例数 百分率(%)
BMI<18.5 175 7 4.0 19 10.9 1 0.6 2 1.1
18.5≤BMI≤23.9 3829 902 23.6 648 16.9 271 7.1 601 15.7
24≤BMI≤27.9 4538 2103 46.3 979 21.6 595 13.1 2379 52.4
BMI≥28 1458 877 60.2 358 24.6 272 18.7 1209 82.9
χ2值 ? 832.997 56.154 180.206 2381.969
P值 ? 0.000 0.000 0.000 0.000
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