High-Density Lipoprotein Cholesterol Negatively Associated with Nonalcoholic Fatty Liver Disease in Non-Diabetic and Normal Weight Adults

高密度膽固醇對非糖尿病及正常體重成人產生非酒精性脂肪肝病之負相關影響

王品超(Pin-Chao Wang) ； 許景盛(Ching-Sheng Hsu) ； 林憲宏(Hans Hsien-Hong Lin) ； 王嘉齊(Chia-Chi Wang)

《臺灣消化醫學雜誌》 27卷4期 (2010/12) Pp. 396-402

https://doi.org/10.6557/GJT.201012_27(4).0001

摘要

背景及目的：非酒精性脂肪肝病一般認爲和肥胖及糖尿病相關，然而此種疾病在非糖尿病及正常體重族群也並非罕見。有關非酒精性脂肪肝病在非糖尿病及正常體重族群之可能相關因子目前仍然未明有待證實。
研究對象及方法：本研究總共有207位受檢者加入收案，包含從2006年9月至2007年12月至慈濟醫院台北分院健康管理中心進行健檢者，並符合非糖尿病（空腹血糖小於126 mg/dL及無過往糖尿病史）和具備正常體重之條件（身體質量指數小於24 kg/平方公尺），且其血清檢驗B型肝炎表面抗原及C型肝炎抗體皆爲陰性，飲酒量均少於每週140 g。所有收案者均記錄其基本資料及收集其臨床檢驗數值進行統計分析，胰島素阻抗性指標乃藉由(HOMA-IR)公式計算而得，收案者根據超音波診斷下脂肪肝之有無分爲非酒精性脂肪肝病及健康對照組兩組。
結果：在非糖尿病及正常體重之受檢者當中，經由單變項分析發現，非酒精性脂肪肝病的病患相較於健康對照組而言有較高之身體質量指數，胰島素阻抗性，三酸甘油酯，總膽固醇，及低密度膽固醇，卻有較低之高密度膽固醇。進一步多變項分析顯示高密度膽固醇爲獨立因子且和非酒精性脂肪肝病的產生呈現負相關性（勝算比0.93；95%信賴區間0.89-0.98；P值＜0.01）。
結論：血清中高密度膽固醇數值和在非糖尿病及正常體重族群之非酒精性脂肪肝病的發生呈現負相關性，這意味著高密度膽固醇對於此類族群非酒精性脂肪肝病的產生可能扮演特定的角色。

關鍵字

高密度膽固醇 ； 非酒精性脂肪肝病 ； 胰島素阻抗性

並列摘要

Goals and Background: Although non-alcoholic fatty liver disease (NAFLD) is closely associated with obesity and diabetes mellitus, it is not rare in non-diabetic and normal weight subjects. Which factors are associated with the presence of NAFLD in this special population remains unclear.
Materials and Methods: A total of 207 non-diabetic (fasting plasma glucose＜126 mg/dL and without previous diabetic history) and normal weight (body mass index＜24 kg/m^2) individuals attending a health examination center were enrolled since September 2005 to December 2006. All the subjects were negative for serum hepatitis B surface antigen and antibody against hepatitis C virus, and consumed alcohol less than 140 g/week. Insulin resistance index was determined using homeostasis model assessment (HOMA-IR).
Results: 70 subjects (33.8%) were identified to have ultrasonographic NAFLD, and remaining 137 (66.2%) served as controls. There was no significant difference in age and gender distribution between two groups. In nondiabetic and normal weight individuals, patients of NAFLD had raised body mass index, HOMA-IR, triglyceride, total cholesterol and low-density lipoprotein cholesterol, but reduced high-density lipoprotein cholesterol (HDL-C) as compared to controls by univariate analyses. Multivariate logistic regression analyses showed a negative association between HDL-C and the presence of NAFLD (odds ratio, 0.93; 95% confidence interval, 0.89-0.98; P＜0.01).
Conclusions: Serum HDL-C level has a negative association with NAFLD in non-diabetic and normal weight adults, independent of other metabolic factors or insulin resistance.

並列關鍵字

High-density lipoprotein cholesterol ； nonalcoholic fatty liver disease ； insulin resistance