广东省农村社区居民脂肪肝流行病学调查

*基金项目:广州市卫生科研基金重点项目(2004Z001)

作者单位:11南方医科大学生物统计学系,广州510515;21广州

医学院预防医学系;31广州医学院附属市第一人民医院消化科

作者简介:马金香(1972-),女,安徽天长人,讲师,硕士,研究方

向:慢性病流行病学与统计方法。

通讯作者:李喻元

文章编号:1001-0580(2007)07-0874-03 中图分类号:R 181.38 文献标志码:A

=调查研究与分析>

广东省农村社区居民脂肪肝流行病学调查*

马金香

1,2

,周永健3,陈平雁1,聂玉强3,石胜利3,李瑜元

3

摘 要:目的 了解广东省农村社区居民脂肪肝患病情况及其影响因素。方法 采用多阶段抽样方法抽取广东

省农村社区7岁以上常住居民2043人进行问卷、查体和实验室检查,包括吸烟饮酒、饮食状况、体格检查、肝脏B 超以及生化检测。结果 共检出脂肪肝264人,患病率为12.9%(男性为13.7%,女性为12.5%);酒精性脂肪肝、疑似酒精性脂肪肝和非酒精性脂肪肝的患病率分别为015%,113%和1111%;随着年龄的升高脂肪肝患病率升高,50岁以前男性的患病率高于女性(V 2=13.985,P <01001);儿童青少年(7~18岁)脂肪肝患病率为114%(5/367),皆为非酒精性脂肪肝,成人(18岁及以上)脂肪肝患病率为1515%,酒精性、疑似酒精性、非酒精性脂肪肝患病率分别为0166%,1161%,13119%;按年龄、性别标准化后广东省农村脂肪肝7岁及以上人口患病率为10154%,酒精性、疑似酒精性、非酒精性脂肪肝的标化率分别为0155%,1152%和8134%;广东省农村成人脂肪肝标化率为13181%(酒精性、疑似酒精性、非酒精性脂肪肝的标化率分别为0174%,211%和10195%)。广东省农村成人脂肪肝病因单因素分析结果表明,年龄、性别、文化程度、饮酒、饮食口味偏咸、超重、肥胖、高血压、腰臀比、腰围以及血液化验指标甘油三酯(T G )、总胆固醇(T C)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(L DL-C)和血糖与脂肪肝发生有关。多因素非条件Log istic 回归分析结果显示,除了年龄、性别与脂肪肝有关外,饮酒、饮食口味偏咸、体质指数、腰围、腰臀比、血清甘油三酯、空腹血糖以及高血压等指标与脂肪肝有关。结论 广东省农村居民脂肪肝主要为非酒精性脂肪肝,成人脂肪肝主要与饮酒、饮食和多元代谢紊乱关系密切。

关键词:脂肪肝;流行病学;患病率;危险因素Epidemiological survey on f atty liver in rural area of Guangdong province MA Jin -x iang ,Z H O U Yong -j ian,CH EN Ping -yan ,et al.Dep ar tment of Medical Statistics,Souther n M edical Univ ersity (Guangz hou 510515,China)

Abstract :Objective T o investigate the pr evalence and major r isk factors of fatty liver among the general population in rural area of Guangdong prov ince.Methods 2043residents aged 7years and abo ve were selected by mult-i stage sampling in

Guang dong prov ince.Q uestionnaire about smoking ,alco hol consumption,diet,physical ex amination,liver ultrasonog raphy and ser ological tests w er e carried out.Results A to tal of 264residents w er e detected wit h fatty liver which prevalence w as 12.9%(male 13.7%,female 12.5%),the pr evalence of alcoholic fatty liver,suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.5%,1.3%and 11.1%respectively.T he prev alence of fatty liver was increased with the age in males and females.A mong participants younger than 50years old,the prev alence of fatty liver in males w as sig nificantly hig her than that in females(V 2=13.985,P <0.001).T he prevalence of fatty liver in children(7~18years old)w as 1.4%(5/367),all of them were nonalcoholic fatty liv er ,while the prevalence of fatty liver in adults was 15.5%,the pr evalence of alcoho lic fatt y liver,suspected alco holic fatty liver and nonalcoholic fatty liver w ere 0.66%,1.61%and 13.19%respectively.A fter being adjust ed for ag e and sex ,t he standar dized prevalence of fatt y liver in 7years and abov e was 10.54%,the standardized pr eva -lence of alco holic fatty liv er ,suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.55%,1.52%and 8.34%re -spectiv ely.T he standar dized prevalence of fatty liver in adults w as 13.81%,t he standardized prevalence of alcoholic fatt y liv -er,suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.74%,2.1%and 10.95%respectively.Risk factors asso -ciated w ith fatty liver in rur al adults of Guangdong province with single v ar iate analysis demonstr ated that r i sk factors such as the age,sex ,education lev el,dr inking,diet,body mass index (BM I ),waist circumfer ence(WC),w aist hip ratio(WHR),blood pressure,fast ing ser um g lucose,triglyceride (T G),total cholester ol (T C),high-and low -density lipoprotein cho lestero l lev el were related to fatty liv er.Log istic regression analysi s demo nstrated that female,educational level were protective factors o f fatty liver while r isk facto rs such as drinking ,salty favor ,BM I ,WC,WHR,T G,fasting serum glucose and hyper tension were positively corr elated to fatty liver.Conclusion T he major ty pe of fatty liver in rural area of Guangdong province is non -alcoholic fatty liver,alcoholic consumption,diet and met abolic disorders ar e closely associated w ith fatty liv er in rur al adults of Guang dong prov ince.

Key words :fatty liver;epidemiological survey;prevalence;risk factors;rural area 近年来,随着饮食结构和生活习惯的改变,脂肪肝的发病率明显上升,其发生与饮酒、高代谢综合征密切相关,部分患者可以发展为肝硬化、肝癌

112

。广东省地处中国南方,有独特

的生活方式和饮食习惯,特别是外来人口较少的农村地区的

人群。为了解广东省农村居民脂肪肝的发病情况及其相关因素,于2005年7~11月在广东省农村地区进行了居民脂肪肝的流行病学调查,并对其有关的危险因素进行分析。1 对象与方法

111 对象 广东省农村地区年龄>7岁的常住居民;采用多阶段分层随机整群抽样方法,抽取广东省广州市郊区花都区的石南村659人,同时随机抽取广东省周边地区农村,东北部的惠州河南岸区1037人、西南部的湛江的调顺村351人,共计2047人。

112 方法 自行设计脂肪肝调查问卷。调查内容包括一般