代谢正常肥胖疾病与非酒精性脂肪性肝病的相关性研究

【目的】探讨代谢正常肥胖（metabolically healthy obese ，M HO ）与非酒精性脂肪性肝病（nonalco-holic fatty liver disease ，NAFLD）的相关性。【方法】收集本院2006年4月至2010年1月体检者资料，记录体检个体的各项临床指标、相关生化指标及腹部B超结果，排除资料不全者，共2830例。根据肥胖的诊断标准，共有613例纳入本研究，包括M HO 261例，肥胖伴代谢综合征（metabolic syndrome ，MS）352例。对其中M HO合并NAFLD者（ n＝134）、未合并NAFLD者（ n＝127）及MS（ n＝352）者的一般资料、血压、血糖、血脂、尿酸、外周血白细胞计数（WBCC）进行分析，并对109例MHO（其中MHO合并NAFLD者62例）随访1～3年。观察 M HO 合并 NAFLD 者发生 MS 的情况。【结果】① M HO 中，未合并 NAFLD 组体质指数（BMI）、年龄、收缩压（SBP）均较合并NAFLD组低，且差异有显著性（ P＜0．05）。合并NAFLD组BMI、年龄与肥胖伴MS组相比无统计学差异，SBP较肥胖伴MS组低，较未合并NAFLD组高，且差异有显著性（ P ＜0．05）。②M HO中合并NAFLD组代谢异常性疾病的发病率较未合并NAFLD组高（59．68％ vs 29．79％，P＜0．05）。【结论】①M HO合并NAFLD者临床及生化特征与肥胖伴MS者更相近。② NAFLD是M HO向代谢异常性疾病进展的危险因素。

Study on the Correlation Between Metabolically Healthy Obese and Nonalcoholic Fatty Liver Disease

Objective] To explore the correlation between metabolically healthy obese（MHO） and nonal-coholic fatty liver disease（NAFLD） .Methods] The data of physical examination subjects in our hospital from April 2006 to Jan .2010 were collected .All clinical indicators ,biochemical indexes and abdominal B-ultrasound results of subjects were recorded .There were 2830 cases excluding those with the missing data .According to the diagnostic criteria of obesity ,613 subjects including 261 cases of M HO and 352 cases of MS were enrolled in the study .General data such as blood pressure ,blood sugar ,lipids ,uric acid and white blood cell count （WBCC） in peripheral blood of 134 cases of M HO with NAFLD ,127 cases of M HO without NAFLD and 352 cases of MS were analyzed .Among them ,109 cases of MHO（including 62 cases of MHO with NAFLD） were followed up for 1~3 years .The incidence of MS in M HD with NAFLD was observed .Results]Body mass in-dex（BMI）,ageandsystolicbloodpressure（SBP）inthegroupofMHOwithoutNAFLDwerelowerthanthose in the group of M HO with NAFLD ,and there was significant difference（ P〈0 .05） .There was no significant difference in BMI and age between the group of MHO with NAFLD and the group of obesity with MS .SBP in the group of M HO with NAFLD was lower than that in the group of obesity with MS ,but higher than that in the group of MHO without NAFLD ,and there was significant difference （ P〈0 .05） .The incidence of abnor-mal metabolic diseases in the group of M HO with NAFLD was higher than that in the group of M HO without NAFLD（59 .68% vs .29 .79% ,OR=3 .489 ,95% CI：1 .559-7 .804 ,P 〈0 .05） .Conclusion] Clinical and biochemical features of the subjects with M HO and NAFLD is closer to those of the subjects with obesity and MS .NAFLD may be a risk factor of M HO developing to abnormal metabolic diseases .