非酒精性脂肪肝與代謝症候群組成因子相關性之分析：以台中市一醫學中心為例

Relationship between Nonalcoholic Fatty Liver and the Components of Metabolic Syndrome: A Hospital-based Study

何幸穎(Hsing-Ying Ho) ； 賴學洲(Hsueh-Chou Lai) ； 賴明美(Ming-May Lai) ； 賴世偉(Shih-Wei Lai) ； 林文元(Wen-Yuan Lin) ； 林獻峰(Hsien-Fong Lin) ； 林志學(Chih-Hsueh Lin) ； 劉秋松(Chiu-Shong Liu) ； 林璨(Tsann Lin)

《Mid-Taiwan Journal of Medicine》 11卷1期 (2006/03) Pp. 35-41

https://doi.org/10.6558/MTJM.2006.11(1).5

摘要

目的　探討非酒精性脂肪肝與代謝症候群組成因子間的相關性。
方法　以2000年1月至2002年12月間到台中市某醫學中心自費健康檢查的民眾為樣本，排除問卷調查回答每天仍在喝酒者與C型肝炎抗體陽性的民眾，本研究納入總共2550位民眾。脂肪肝的診斷是請腸胃專科醫師採用國際認定標準以超音波診斷。代謝症候群的定義是依美國國家膽固醇教育委員會針對成人的建議，以下五項符合三項或三項以上即定義為代謝症候群：一）曾有糖尿病病史、或空腹血糖值≥6.1 mmol/L。二）三酸甘油酯值≥1.7 mmol/L。三）男性高密度膽固醇值＜1 mmol/L，女性高密度膽固醇值＜1.3 mmol/L。四）曾有高血壓病史、或收縮壓值≥130 mmHg、或舒張壓值≥85 mmHg。五）肥胖的判定是採用衛生署的標準，男性腰圍≥90公分，女性腰圍≥80公分。統計方法採用卡方檢定檢定組間的差異，再以多變項邏輯式迥歸分析檢定非酒精性脂肪肝與相關因子間的關係。
結果　男性佔1334人(52.3%)，女性佔1216人(47.7%)，平均年齡為49.5±12.3歲（範圍20至87歲）。多變項邏輯式迥歸分析發現，男性比女性容易罹患非酒精性脂肪肝（勝算比2.49）。中央性肥胖的人比非肥胖的人容易罹患非酒精性脂肪肝（勝算比3.57）。高血壓的人比血壓正常的人容易罹患非酒精性脂肪肝（勝算比1.44）。血糖偏高的人比血糖正常的人容易罹患非酒精性脂肪肝（勝算比1.80）。高三酸甘油酯血症的人比三酸甘油酯正常的人容易罹患非酒精性脂肪肝（勝算比3.01）。高密度膽固醇偏低的人比高密度膽固醇正常的人容易罹患非酒精性脂肪肝（勝算比1.81）。此外，40至64歲的人比20至39歲的人容易罹患非酒精性脂肪肝（勝算比1.34）。
結論　非酒精性脂肪肝與代謝症候群組成因子之間有顯著相關性。

關鍵字

實證醫學 ； 非酒精性脂肪肝 ； 代謝症候群 ； 盛行率

並列摘要

Purpose. To explore the relationship between nonalcoholic fatty liver and metabolic syndrome.
Methods. This was a hospital-based, cross-sectional study. We retrospectively analyzed all patients receiving periodic health check-ups at one medical center located in Taichung city from January 2000 to December 2002. Subjects who habitually drank alcohol and who had hepatitis C virus antibody were excluded. In total, 2550 people were enrolled in this study. Fatty liver was diagnosed according to abdominal ultrasonography. According to the ATP Ⅲ criteria, metabolic syndrome is characterized by the presence of three or more of the following components: 1) Hyperglycemia: diagnosed if people had a history of diabetes or fasting plasma glucose ≥6.1 mmol/L; 2) Hypertriglyceridemia: defined as fasting triglyceride ≥1.7 mmol/L; 3) Low level of HDL: defined as fasting HDL ＜1 mmol/L for men and ＜1.3 mmol/L for women; 4) High blood pressure: diagnosed if people had a history of hypertension or blood pressure ≥130/85 mmHg; 5) Central obesity: defined as waist circumference ≥90 cm for men and ≥80 cm for women, according to the Department of Health, Taiwan. The chi-square test and multivariate logistic regression analysis were used.
Results. There were 1334 men (52.3%) and 1216 women (47.7%). The mean age was 49.5±12.3 years (age range, 20 to 87 years). Multivariate logistic regression analysis showed that the significant risk factors for nonalcoholic fatty liver were central obesity (OR=3.57), high blood pressure (OR=1.44), hyperglycemia (OR=1.80), hypertriglyceridemia (OR=3.01) low levels of high density lipoprotein cholesterol (OR=1.81) and being male (OR=2.49). People aged 40 to 64 years were more likely to have nonalcoholic fatty liver than people aged 20 to 39 years (OR=1.34).
Conclusions. There is a significant association between nonalcoholic fatty liver and metabolic syndrome.

並列關鍵字

evidence-based medicine ； nonalcoholic fatty liver ； metabolic syndrome ； prevalence