中国肝脏病杂志(电子版)

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非酒精性脂肪性肝病合并代谢综合征与颈动脉粥样硬化的关系

作者：郭方方汪菲戴建业王家宏

单位：解放军总医院国际部三科北京 100853

关键词：脂肪肝非酒精性代谢综合征动脉粥样硬化

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出版年,卷(期):页码：2017,9(3):65-69

摘要：

摘要：目的探讨非酒精性脂肪性肝病（nonalcoholic fatty liver disease，NAFLD）合并代谢综合征
（metabolic syndrome，MS）对颈动脉粥样硬化的影响。方法选取解放军总医院401例体检者为研究
对象，根据NAFLD和MS的患病情况将研究对象分为4组：NAFLD合并MS组（A组），仅患NAFLD无
MS组（B组），仅MS无NAFLD组（C组），无NAFLD及MS组（D组），对4组间颈动脉粥样硬化发
病率进行比较分析。采用Logistic回归分析各因素对颈动脉粥样硬化的影响。结果 A～D组患者颈动脉
粥样硬化的发病率分别为58.65%、21.92%、36.84%和1.87%，组间差异有统计学意义（χ 2 =73.5，P ＜
0.001），经修正后以α = 0.007为标准，A组与C组间差异无统计学意义（χ 2 = 10.31，P = 0.02），其余
各组间的差异均有统计学意义（P ＜ 0.05）。C组发病率高于B组，差异有统计学意义（χ 2 = 12.47，P =
0.023）。BMI、臀围比、血脂水平、空腹血糖以及是否患有NAFLD、MS均对颈动脉粥样硬化的发生
有显著影响。结论 MS及NAFLD均可增加颈动脉粥样硬化发病的风险。MS对动脉粥样硬化发生的影响
高于NAFLD。

Abstract: Objective To investigate the effects of non-alcoholic fatty liver disease (NAFLD) combined
with metabolic syndrome (MS) on carotid atherosclerosis. Methods Total of 401 cases who got physical
examination in Chinese PLA General Hospital were selected and divided into 4 groups (group A～D): people
in group A were with NAFLD and MS, people in group B were with NAFLD and without MS, people in group
C were with MS and without NAFLD, people in group D were without NAFLD or MS. The incidence rate of
carotid atherosclerosis were analyzed among the groups. Logistic regression analysis was used to analyze the
effects of each factor on carotid atherosclerosis. Results The incidence rate of carotid atherosclerosis in group
A～D were 58.65%, 21.92%, 36.84% and 1.87%, respectively, the differences were statistically significant
(χ 2 = 73.5, P ＜ 0.001). After modification, α = 0.007 was taken as the statistical standard. The difference
of carotid atherosclerosis incidence rate between group A and group C had no statistical significance (χ 2 =
10.31, P = 0.02), while the differences between the other groups were statistically significant (P ＜ 0.05). The
incidence rate of carotid atherosclerosis in group C was higher than that in group B (χ 2 = 12.47, P = 0.023).
The occurrence of carotid artery atherosclerosis was significantly influenced by BMI, hip circumference ratio,
blood lipid levels, fasting glucose, NAFLD and MS. Conclusions Both MS and NAFLD can increase the risk
of carotid atherosclerosis. The effect of MS on atherosclerosis is higher than that of NAFLD.

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