非酒精性脂肪肝患者合并高血压的相关危险因素分析-现代医学

非酒精性脂肪肝患者合并高血压的相关危险因素分析

单位：1. 南京大学医学院附属鼓楼医院药学部, 江苏南京 210008;
2. 南京市中医院感染科, 江苏南京 210001;
3. 南京中医药大学附属医院/江苏省中医院感染科, 江苏南京 210029

分类号：R575.1

出版年·卷·期（页码）：2022·50·第七期（806-810）

摘要：

目的：分析非酒精性脂肪肝（non-alcoholic fatty liver disease，NAFLD）患者的临床特点，并研究其合并高血压的危险因素。方法：回顾分析2014年1月至2020年12月在南京中医药大学附属医院住院的NAFLD患者的临床资料。根据NAFLD患者是否合并高血压分为NAFLD组和NAFLD合并高血压组，两组间比较用单因素分析（t检验、Mann-Whitney U检验、卡方检验），非条件二分类Logistic回归分析筛选NAFLD合并高血压的危险因素。结果：共纳入符合NAFLD入选标准者351例，其中合并高血压患者163例。两组患者在年龄、体质量指数（body mass index，BMI）、糖尿病、丙氨酸氨基转移酶（alanine transferase，ALT）、天门冬氨酸氨基转移酶（aspartate aminotransferase，AST）、谷氨酰转肽酶（gamma-glutamyl transferase，GGT）、总胆固醇（total cholesterol，TC）方面的差异均有统计学意义（P<0.05）。多因素回归分析提示，年龄（OR=1.060，P<0.001）、BMI（OR=1.091，P=0.022）、是否合并糖尿病（OR=1.782，P=0.024）为NAFLD合并高血压的影响因素。结论：高龄、高BMI值及糖尿病是NAFLD合并高血压的危险因素。

Objective: To analyze the clinical features of patients with non-alcoholic fatty liver disease(NAFLD) and to explore the risk factors for NAFLD combined with hypertension. Methods: Clinical data of NAFLD patients admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2014 to December 2020 were retrospectively analyzed. Comparison between patients with NAFLD with or without hypertension was conducted by univariate analysis, and risk factors for NAFLD combined with hypertension were screened by unconditional binary Logistic regression analysis. Results: A total of 351 patients who met the inclusion criteria were included, including 163 patients with hypertension. Their age, body mass index (BMI), diabetes, alanine transferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total cholesterol (TC) were significantly different(P<0.05). Subsequent multivariate regression analysis showed that age(OR=1.060, P<0.001), BMI(OR=1.091, P=0.022) and diabetes mellitus(OR=1.782, P=0.024) were risk factors of NAFLD with hypertension. Conclusion: Advanced age, high BMI value and diabetes mellitus are the risk factors for NAFLD combined with hypertension.

参考文献：

[1] ZHOU F, ZHOU J, WANG W, et al.Unexpected rapid increase in the burden of NAFLD in China from 2008 to 2018:a systematic review and Meta-analysis[J].Hepatology, 2019, 70:1119-1133.
[2] YOUNOSSI Z, TACKE F, ARRESE M, et al.Global perspectives on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis[J].Hepatology, 2019, 69(6):2672-2682.
[3] ANSTEE Q M, REEVES H L, KOTSILITI E, et al.From NASH to HCC:current concepts and future challenges[J].Nat Rev Gastroenterol Hepatol, 2019, 16:411-428.
[4] PARTHASARATHY G, REVELO X, MALHI H.Pathogenesis of nonalcoholic steatohepatitis:an overview[J].Hepatol Commun, 2020, 4(4):478-492.
[5] YOUNOSSI Z, RINELLA M, SANYAL A, et al.From NAFLD to MAFLD:implications of a premature change in terminology[J].Hepatology, 2021, 73:1194-1198.
[6] 范建高.中国非酒精性脂肪性肝病诊疗指南(2010年修订版)[J].中国医学前沿杂志(电子版), 2012, 4(7):4-10.
[7] 中国高血压防治指南修订委员会.2004年中国高血压防治指南(实用本)[J].诞辰杂志, 2004, 12(23):483-486.
[8] LONARDO A, NASCIMBENI F, MANTOVANI A, et al.Hypertension, diabetes, atherosclerosis and NASH:cause or consequence?[J].J Hepatol, 2018, 68(2):335-352.
[9] 赵天慧, 魏强, 刘茜.非酒精性脂肪肝患者的受控衰减参数与脂代谢异常及颈动脉粥样硬化的关系[J].东南大学学报(医学版), 2020, 39(6):4.
[10] SHEKA A C, ADEYI O, THOMPSON J, et al.Nonalcoholic steatohepatitis:a review[J].JAMA, 2020, 323(12):1175-1183.
[11] ZHAO Y, ZHAO G, CHEN Z, et al.Nonalcoholic fatty liver disease:an emerging driver of hypertension[J].Hypertension, 2020, 75:275-284.
[12] ZHANG T, ZHANG C, ZHANG Y, et al.Metabolic syndrome and its components as predictors of nonalcoholic fatty liver disease in a northern urban Han Chinese population:a prospective cohort study[J].Atherosclerosis, 2015, 240(1):144-148.
[13] ANENI E C, ONI E T, MARTIN S S, et al.Blood pressure is associated with the presence and severity of nonalcoholic fatty liver disease across the spectrum of cardiometabolic risk[J].J Hypertens, 2015, 33(6):1207-1214.
[14] GAWRIEH S, WILSON L A, CUMMINGS O W, et al.Histologic findings of advanced fibrosis and cirrhosis in patients with nonalcoholic fatty liver disease who have normal aminotransferase levels[J].Am J Gastroenterol, 2019, 114(10):1626-1635.
[15] JOHNSTON M P, PATEL J, BYRNE C D.Multi-drug approaches to NASH:what's in the development pipeline?[J].Expert Opin Investig Drugs, 2020, 29(2):143-150.
[16] SORRENTINO P, TERRACCIANO L, D'ANGELO S, et al.Predicting fibrosis worsening in obese patients with NASH through parenchymal fibronectin, HOMA-IR, and hypertension[J].Am J Gastroenterol, 2010, 105(2):336-344.
[17] PITISUTTITHUM P, CHAN W K, PIYACHATURAWAT P, et al.Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty liver disease:the GOASIA study[J].BMC Gastroenterol, 2020, 20(1):88.
[18] LABENZ C, HUBER Y, KALLIGA E, et al.Predictors of advanced fibrosis in non-cirrhotic non-alcoholic fatty liver disease in Germany[J].Aliment Pharmacol Ther, 2018, 48(10):1109-1116.
[19] KANWAL F, KRAMER J R, LI L, et al.Effect of metabolic traits on the risk of cirrhosis and hepatocellular cancer in nonalcoholic fatty liver disease[J].Hepatology, 2020, 71(3):808-819.
[20] 黎娜.体重指数和腰高比联合评估非酒精性脂肪性肝病发病风险的研究[D].大连:大连医科大学, 2021.

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