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摘要：
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摘要：目的 探讨炎症肠病（inflammatory bowel disease，IBD）患者非酒精性脂肪性肝病（non-alcoholic
fatty liver disease，NAFLD）患病情况及相关危险因素。方法 以2017年1月至2019年10月新疆军区总医
院收治的409例IBD患者为研究对象，应用腹部超声筛查NAFLD，根据是否合并NAFLD分为NAFLD组
（131例）和对照组（278例），比较两组患者年龄、性别、体重指数（body mass index，BMI）、腹围、
病程及并发症（高血压、糖尿病、吸烟）、天门冬氨酸氨基转移酶（aspartate aminotransferase，AST）、
丙氨酸氨基转移酶（alanine aminotransferase，ALT）、γ-谷氨酰转移酶（gamma-glutamyltransferase，
GGT）、白蛋白、糖化血红蛋白（glycosylated hemoglobin，HbA1c）、低密度脂蛋白胆固醇（low
density lipoprotein cholesterol，LDL-C）、血肌酐、估算肾小球滤过率（estimated glomerular filtration rate，
eGFR）和C-反应蛋白（C-reactive protein，CRP）等的差异。采用Logistic回归分析IBD患者发生NAFLD
的独立危险因素。结果 IBD患者NAFLD的患病率为32.03%（131/409）。NAFLD组患者年龄[（50.24 ±
12.83）岁vs（38.74 ± 10.91）岁]、BMI [（28.24 ± 4.90）kg/m2 vs（23.52 ± 3.73）kg/m2
]、腹围[（93.10 ±
11.52）cm vs（85.52 ± 10.06）cm]、病程[（8.52 ± 1.84）年vs（5.84 ± 1.28）年]、高血压比例[20.61%
（27/131）vs 4.68%（13/278）]、糖尿病比例[9.92%（13/131）vs 1.80%（5/278）]、吸烟比例[50.38%
（66/131）vs 38.13%（106/278）]、GGT [（26.57 ± 8.19）U/L vs（18.46 ± 4.36）U/L]和HbA1c [（6.65 ±
2.17）% vs（3.64 ± 1.05）%]水平均显著高于对照组，差异有统计学意义（P均＜ 0.05）。多因素
Logistic回归分析表明年龄（OR = 1.33，95%CI：1.15～1.82，P = 0.018）、BMI（OR = 1.80，95%CI：
1.25～3.27，P = 0.002）、病程（OR = 2.60，95%CI：1.10～3.26，P = 0.010）和糖尿病（OR = 1.77，
95%CI：1.23～4.79，P = 0.006）是IBD患者发生NAFLD的独立危险因素。结论 IBD患者NAFLD的患
病率高，年龄、BMI、病程和糖尿病均是IBD患者发生NAFLD的独立危险因素，可通过促进健康生活
方式进行代谢干预，以减少NAFLD的发生。
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Abstract: Objective To investigate the prevalence and related risk factors of non-alcoholic fatty liver disease
(NAFLD) in patients with inflammatory bowel disease (IBD). Methods A total of 409 patients with IBD in General
Hospital of Xinjiang Military Region from January 2017 to October 2019 were enrolled. Abdominal ultrasound
was used to identify NAFLD. The patients were divided into NAFLD group (131 cases) and control group (278
cases) according to whether combined with NAFLD or not. The differences of age, gender, body mass index
(BMI), abdominal circumference, course of disease, complications (including hypertension, diabetes and smoking)
and aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT),
glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), serum creatinine, estimated
glomerular filtration rate (eGFR) and C-reactive protein (CRP) of patients between the two groups were
compared. Logistic regression analysis was used to analyze the independent risk factors of NAFLD in patients
with IBD. Results In patients with IBD, the prevalence of NAFLD was 32.03% (131/409). Age [(50.24 ±
12.83) years old vs (38.74 ± 10.91) years old], BMI [(28.24 ± 4.90) kg/m2 vs (23.52 ± 3.73) kg/m2
], abdominal
circumference [(93.10 ± 11.52) cm vs (85.52 ± 10.06) cm], course of disease [(8.52 ± 1.84) yeras vs (5.84 ±
1.28) years], hypertension rate [20.61% (27/131) vs 4.68% (13/278)], diabetes rate [9.92% (13/131) vs 1.80%
(5/278)], smoking rate [50.38% (66/131) vs 38.13% (106/278)], GGT [(26.57 ± 8.19) U/L vs (18.46 ± 4.36) U/L]
and HbA1c [(6.65 ± 2.17)% vs (3.64 ± 1.05)%] levels of patients in NAFLD group were significantly higher
than those of control group, the differences were statistically significant (all P ＜ 0.05). Logistic regression
analysis showed that age (OR = 1.33, 95%CI: 1.15～1.82, P = 0.018), BMI (OR = 1.80, 95%CI: 1.25～3.27,
P = 0.002), course of disease (OR = 2.60, 95%CI: 1.10～3.26, P = 0.010) and diabetes (OR = 1.77, 95%CI:
1.23～4.79, P = 0.006) were independent risk factors of NAFLD in patients with IBD. Conclusions The
prevalence of NAFLD is high in patients with IBD. Age, BMI, course of disease and diabetes are independent
risk factors of NAFLD in patients with IBD. Metabolic intervention should be carried out by promoting
healthy lifestyle to reduce the incidence of NAFLD in patients with IBD.
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