上海社区中老年人群脂肪肝指数与微量白蛋白尿的相关性研究

诊断学理论与实践››2020,Vol. 19››Issue (06): 605-609.doi:10.16150/j.1671-2870.2020.06.011

上海社区中老年人群脂肪肝指数与微量白蛋白尿的相关性研究

左广民, 彭魁, 李勉, 徐敏, 毕宇芳, 宁光()

国家代谢性疾病临床医学研究中心上海市内分泌代谢病研究所开云网页登录医学院附属瑞金医院内分泌代谢病科,上海 200025

收稿日期:2016-12-20出版日期:2020-12-25发布日期:2022-07-14
通讯作者:宁光 E-mail:guangning@medmail.com.cn
基金资助:
上海卫生系统重要疾病联合攻关项目(2013ZYJB1002)

The association between fatty liver index and microalbuminuria in middle-aged and elderly population in Shanghai

ZUO Guangmin, PENG Kui, LI Mian, XU Min, BI Yufang, NING Guang()

Shanghai Clinical Center for Endocrine and Metabolic Diseases; Shanghai Institute of Endocrine and Metabolic Diseases; Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2016-12-20Online:2020-12-25Published:2022-07-14
Contact:NING Guang E-mail:guangning@medmail.com.cn

摘要/Abstract

摘要：

目的：探讨脂肪肝指数（fatty liver index, FLI）与微量白蛋白尿间的相关性。方法：于2009年选取上海淞南地区40岁以上的居民4 012人进行横断面调查,采用问卷调查、体格检查等收集相关资料,观察其微量白蛋白尿情况,并计算FLI,分析该人群中FLI与微量白蛋白尿间的相关性。结果：最终共有3 415人纳入分析,结果提示,随着FLI的升高,不同FLI分组[低FLI组（FLI<30）、中FLI组（30≤FLI<60）和高FLI组（≥60）]中微量白蛋白尿患病率逐渐增加,3组的微量白蛋白尿患病率分别为6.86%、10.99%、15.28%（P<0.000 1）。在校正年龄、性别、吸烟、饮酒、运动、高血压、糖尿病、总胆固醇后,与低FLI组相比,高FLI组人群的微量白蛋白尿患病风险增加了58%（OR=1.58,95%CI为1.17~2.15,P=0.003 2）。在同样的校正因素下,FLI数值每增加10,微量白蛋白尿患病风险增加10%（OR=1.10, 95%CI为1.04~1.15,P=0.000 2）。结论：上海淞南地区40岁以上人群中,FLI升高与其微量白蛋白尿的患病风险增加相关。

关键词:脂肪肝指数,微量白蛋白尿,代谢紊乱

Abstract:

Objective:To investigate the association between fatty liver index (FLI) and prevalence of microalbuminuria.Methods:A cross-sectional survey of 4 012 subjects aged 40 years or older in Songnan Community, Shanghai was conducted in 2009. Questionnaire and anthropometric measurements were collected, and microalbuminuria and the FLI were determined. The association between FLI and microalbuminuria was analyzed.Results:Among the 3 415 subjects in the current analysis, the prevalence of microalbuminuria increased with increase of the FLI. The corresponding prevalence of microalbuminuria were 6.86%, 10.99% and 15.28% in low FLI group(FLI<30), intermediate FLI group(30≤FLI<60) and the high FLI group(FLI≥60), respectively (P<0.000 1). After adjustment for age, sex, smoking status, current drinking, physical activity, systolic blood pressure, diabetes and total cholesterol, the high FLI group was associated with 58% increased risk of microalbuminuria compared with the low FLI group (OR=1.58, 95% CI 1.17-2.15,P=0.003 2). In the same adjusting model,the risk in prevalence of microalbuminuria increased 10% for each 10 unit increase in FLI (OR=1.10, 95% CI 1.04-1.15,P=0.000 2).Conclusions:FLI increas is associated with increased risk of microalbuminuria in subjects aged 40 years or older in Songnan Community, Shanghai.

Key words:Fatty liver index,Microalbuminuria,Metabolic disorders

中图分类号:

R575.5

左广民, 彭魁, 李勉, 徐敏, 毕宇芳, 宁光. 上海社区中老年人群脂肪肝指数与微量白蛋白尿的相关性研究[J]. 诊断学理论与实践, 2020, 19(06): 605-609.

ZUO Guangmin, PENG Kui, LI Mian, XU Min, BI Yufang, NING Guang. The association between fatty liver index and microalbuminuria in middle-aged and elderly population in Shanghai[J]. Journal of Diagnostics Concepts & Practice, 2020, 19(06): 605-609.

图/表6

表1

研究人群的基本情况

变量	FLI<30	30≤FLI<60	FLI≥60	P值
人数[例（n）]	1 603(46.9%)	1 092(32.0%)	720(21.1%)
年龄（岁）	59.5±10.0	62.3±9.7	62.1±9.9	<0.000 1
体质量指数（kg/m²）	22.4±2.5	25.8±2.2	29.0±3.5	<0.000 1
腰围（cm）	80.1±6.9	89.8±5.9	98.2±8.0	<0.000 1
吸烟状态[例（n）]	213(13.3%)	184(16.9%)	137(19.0%)	<0.050 0
饮酒状态[例（n）]	130(8.1%)	98(9.0%)	61(8.5%)	0.730 0
体力活动[例（n）]				<0.000 1
低	1 047(65.3%)	772(70.7%)	536 (74.4%)
中等	412(25.7%)	247(22.6%)	151 (21.0%)
高	144(9.0%)	73(6.7%)	33 (4.6%)
收缩压（mmHg）	132±21	142±21	147±22	<0.000 1
舒张压（mmHg）	76±10	79±10	82±10	<0.000 1
总胆固醇（mmol/L）	5.0±0.9	5.2±1.0	5.4±1.0	<0.000 1
高密度脂蛋白胆固醇（mmol/L）	1.4±0.3	1.3±0.3	1.3±0.2	<0.000 1
低密度脂蛋白胆固醇（mmol/L）	2.3±0.6	2.5±0.7	2.5±0.8	<0.000 1
三酰甘油（mmol/L）	1.1(0.8~1.4)	1.7(1.3~2.3)	2.3(1.7~3.3)	<0.000 1
GOT（u/L）	20(17~23)	21(18~25)	24(19~32)	<0.000 1
GPT（u/L）	15(12~21)	21(14~28)	27(19~41)	<0.000 1
γ-GGT（u/L）	18(14~24)	25(19~35)	38(26~57)	<0.000 1
空腹血糖（mmol/L）	5.0(4.6~5.6)	5.3(4.8~6.2)	5.8(5.1~7.3)	<0.000 1
餐后血糖（mmol/L）	6.8(5.6~9.1)	8.7(6.8~13.6)	11.2(7.7~16.5)	<0.000 1
糖化血红蛋白（%）	6.0(5.7~6.4)	6.2(5.9~6.9)	6.7(6.1~7.7)	<0.000 1
HOMA-IR	1.2(0.8~1.8)	2.1(1.4~3.0)	3.3(2.3~5.0)	<0.000 1
尿白蛋白/肌酐比值	4.9(2.5~10.1)	6.2(2.9~13.1)	7.9(3.4~18.3)	<0.000 1
估算肾小球滤过率[mL/（min·1.73 m²）]	114.0±46.6	110.3±23.8	108.5±27.1	<0.050 0
高血压	572(35.7%)	619(56.7%)	461(64.0%)	<0.000 1
糖尿病	335(21.0%)	405(37.1%)	378(52.5%)	<0.000 1

表1

图1

图2

图3

图4

校正模型	OR（95%CI）
FLI/10	1.17(1.12~1.22)	1.16(1.11~1.21)	1.10(1.04~1.15)
P值	<0.000 1	<0.000 1	0.000 2
FLI<30	1.00	1.00	1.00
30≤FLI<60	1.68(1.28~2.20)	1.55(1.18~2.04)	1.25(0.94~1.67)
FLI≥60	2.45(1.85~3.24)	2.27(1.71~3.01)	1.58(1.17~2.15)
P值	<0.000 1	<0.000 1	0.003 2

表2

参考文献13

[1]	Byrne CD, Targher G. NAFLD: a multisystem disease[J]. J Hepatol, 2015, 62(1 Suppl):S47-S64.
[2]	Fan JG, Farrell GC. Epidemiology of non-alcoholic fatty liver disease in China[J]. J Hepatol, 2009, 50(1):204-210. doi:10.1016/j.jhep.2008.10.010 URL
[3]	Armstrong MJ, Adams LA, Canbay A,etal. Extrahepatic complications of nonalcoholic fatty liver disease[J]. Hepa-tology, 2014, 59(3):1174-1197.
[4]	Bedogni G, Bellentani S, Miglioli L, et al. The fatty liver index: a simple and accurate predictor of hepatic steatosis in the general population[J]. BMC Gastroenterol, 2006, 6:33. doi:10.1186/1471-230X-6-33 URL
[5]	Huang X, Xu M, Chen Y, et al. Validation of the fatty liver index for nonalcoholic fatty liver disease in middle-aged and elderly chinese[J]. Medicine (Baltimore), 2015, 94(40):e1682. doi:10.1097/MD.0000000000001682 URL
[6]	Hwang ST, Cho YK, Yun JW, et al. Impact of non-alcoholic fatty liver disease on microalbuminuria in patients with prediabetes and diabetes[J]. Intern Med J, 2010, 40(6):437-442. doi:10.1111/j.1445-5994.2009.01979.xpmid:19460054
[7]	Kasapoglu B, Turkay C, Yalcın KS, et al. Increased microalbuminuria prevalence among patients with nonalcoholic fatty liver disease[J]. Ren Fail, 2016, 38(1):15-19. doi:10.3109/0886022X.2015.1106845pmid:26540639
[8]	Kim BJ, Kim BS, Kang JH. The association between serum ferritin level, microalbuminuria and non-alcoholic fatty liver disease in non-diabetic, non-hypertensive men[J]. Clin Exp Hypertens, 2014, 36(6):380-385. doi:10.3109/10641963.2013.827704 URL
[9]	Pedrinelli R, Penno G, Dell'Omo G, et al. Microalbumi-nuria and transcapillary albumin leakage in essential hypertension[J]. Hypertension, 1999, 34(3):491-495. pmid:10489399
[10]	Anstee QM, Targher G, Day CP. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis[J]. Nat Rev Gastroenterol Hepatol, 2013, 10(6):330-344. doi:10.1038/nrgastro.2013.41 URL
[11]	Parvanova AI, Trevisan R, Iliev IP, et al. Insulin resistance and microalbuminuria: a cross-sectional, case-control study of 158 patients with type 2 diabetes and diffe-rent degrees of urinary albumin excretion[J]. Diabetes, 2006, 55(5):1456-1462. pmid:16644705
[12]	郝明丽, 徐敏. 代谢组学在2型糖尿病研究中的应用及进展[J]. 内科理论与实践, 2016, 11(3):191-194.
[13]	林安华, 王晨秀, 霍亚南, 等. 社区糖尿病患者血压水平与慢性肾脏疾病及其进展的相关性研究[J]. 诊断学理论与实践, 2017, 16(2):178-182.