高敏感性C－反應蛋白與身體質量指數、腰圍、體脂率的關係－以非酒精性脂肪肝病人為例

The Relationship between High Sensitivity C-reactive Protein and Body Mass Index, Waist Circumference, Percent Body Fat Mass in Patients with Non-alcoholic Fatty Liver Disease

蔡坤原(Kun-Yuan Tsai) ； 黃鈞源(Chun-Yuan Huang) ； 黃麗卿(Lee-Ching Hwang)

《台灣家庭醫學雜誌》 27卷4期 (2017/12) Pp. 213-221

https://doi.org/10.3966/168232812017122704003

摘要

背景與目的：非酒精性脂肪肝是現今最常見的慢性肝臟疾病，目前致病生理學尚未完全明瞭，過去有研究發現非酒精性脂肪肝與高敏感性C-反應蛋白有高度的相關性，而非酒精性脂肪肝的第一線治療是控制肥胖。因此本研究欲了解在非酒精性脂肪肝族群各種肥胖評估指標與高敏感性C-反應蛋白的關係。方法：本研究分析2001年至2012年北部某健康檢查中心16,584名非酒精性脂肪肝的病人，採橫斷面研究，收集健康習慣問卷與抽血檢查資料，以多變項迴歸分析比較高敏感性C-反應蛋白與身體質量指數、腰圍、體脂率的關係，並以ROC曲線下面積來比較不同肥胖指標間與高敏感性C-反應蛋白的相關性。結果：總共納入16,584名非酒精性脂肪肝的病人，男女性別分層分析比較後發現，不論性別，經年齡、高血壓病史、糖尿病病史、運動習慣、飲食習慣等變項校正過後，身體質量指數、腰圍、體脂率都與高的高敏感性C-反應蛋白有統計學上顯著的相關性，藉由比較ROC曲線下面積，發現無論性別，體脂率對於高敏感性C-反應蛋白都有最高的相關性。結論：本研究發現在台灣的非酒精性脂肪肝病人，所有的肥胖指標，都與高的高敏感性C-反應蛋白有統計學上顯著意義的相關，而不同指標間比較又以體脂率對於高敏感性C-反應蛋白數值有最高的相關性。

關鍵字

非酒精性脂肪肝 ； 高敏感性C-反應蛋白 ； 身體質量指數 ； 腰圍 ； 體脂率

並列摘要

Purpose: Non-alcoholic fatty liver disease is the most common chronic liver disease in the world. Although the pathophysiology of this disease remains unclear, some studies have identified high sensitive C-reactive protein (hs-CRP) as a strong predictor of this disease. This study examined the relationship between body mass index (BMI), waist circumference (WC), percent body fat mass (%FM) and hs-CRP. Methods: A total of 16,584 subjects undergoing a voluntary health examination at a preventive examination agency were enrolled in this cross-sectional study. Multiple logistic regression analysis was conducted to identify BMI, WC, %FM for the odds ratios of a high level of log hs- CRP after multivariate adjustment. The areas under the curve (AUCs) of the receiver operating characteristic curves were calculated for BMI, WC and %FM to compare their relative ability to correctly classify subjects with a high level of hs-CRP. Results: The odds ratio for all obesity indicators was significantly associated with a high level of hs-CRP both in men and women after multivariate adjustment. The AUCs for %FM were the largest both in men and women, significantly higher than BMI in men, and significantly higher than WC in women. Conclusion: All obesity indicators in patients with non-alcoholic fatty liver disease are strong predictors of high level of hs-CRP. Compared with BMI and WC, %FM appears to be a stronger predictor of high level of hs-CRP.

並列關鍵字

body mass index ； high sensitive C-reactive protein ； non-alcoholic fatty liver disease ； waist circumference ； percent body fat mass

參考文獻

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