台灣中部地區某區域醫院非酒精性脂肪肝疾病與肥胖相關因子之研究

Non-Alcoholic Fatty Liver Disease and Obesity-Associated Factors: A Study in a Regional Hospital in Mid-Taiwan

蔡崇煌(Chung-Huang Tsai) ； 李怡慶(Yii-Ching Lee) ； 羅永杰(Yung-Chieh Ro) ； 周俊德(Chun-Te Chou)

《台灣家庭醫學雜誌》 16卷4期 (2006/12) Pp. 215-225

https://doi.org/10.7023/TJFM.200612.0215

摘要

Non-alcoholic fatty liver disease (NAFLD) may progress to liver fibrosis, cirrhosis, and even end stage liver disease. The aim of the present study was to investigate the relationship between NAFLD and obesity-associated factors among those subjects who underwent health examinations in a regional hospital in Taichung between March 2004 and February 2005. Subjects who drank an average of ＜20 grams of alcohol per day were excluded. A total of 700 participants had an abdominal ultrasonographic examination using a TOSHIBA A220 (convex probe; 3.75MHz), of whom 33.1% of the subjects were diagnosed with NAFLD. Of all subjects, 10.9% were hepatitis B virus carriers and 4.6% were positive for hepatitis C virus. Chi-square analysis showed that increased age, high blood pressure, central obesity, impaired fasting glucose or diabetes mellitus, high triglyceride levels, high total cholesterol levels, low levels of high density lipoprotein-cholesterol, high levels of low density lipoprotein-cholesterol, high aspartate aminotransferase levels, high alanine aminotransferase levels, and hyperuricemia were all associated with NAFLD, and all of these measures reached statistical significance (p＜0.001). The subjects with negative anti-hepatitis C antibody titers had features of NAFLD (p=0.044). The result of a stepwise multivariate logistic regression model revealed that age (Odds Ratio [OR]=1.1; 95% confidence interval [CI] 1.0-1.1), central obesity (OR=4.2; 95% CI 2.8-6.4), impaired fasting glucose or diabetes mellitus (OR=2.3; 95% CI 1.3-4.0), hypertriglyceridemia (OR=2.5; 95% CI 1.7-3.7) and high alanine aminotransferase (OR=2.6; 95% CI 1.6-4.2) were more commonly associated with NAFLD. However, subjects with hepatitis C virus infection weren't predisposed to NAFLD (OR=0.2; 95% CI 0.1-0.7). In conclusion, physicians should consider the possibility of NAFLD, if patients are elderly, have central obesity, impaired fasting glucose or diabetes mellitus, high triglyceride levels, high alanine aminotransferase levels, and negative anti-hepatitis C antibody titers.

並列摘要

Non-alcoholic fatty liver disease (NAFLD) may progress to liver fibrosis, cirrhosis, and even end stage liver disease. The aim of the present study was to investigate the relationship between NAFLD and obesity-associated factors among those subjects who underwent health examinations in a regional hospital in Taichung between March 2004 and February 2005. Subjects who drank an average of ＜20 grams of alcohol per day were excluded. A total of 700 participants had an abdominal ultrasonographic examination using a TOSHIBA A220 (convex probe; 3.75MHz), of whom 33.1% of the subjects were diagnosed with NAFLD. Of all subjects, 10.9% were hepatitis B virus carriers and 4.6% were positive for hepatitis C virus. Chi-square analysis showed that increased age, high blood pressure, central obesity, impaired fasting glucose or diabetes mellitus, high triglyceride levels, high total cholesterol levels, low levels of high density lipoprotein-cholesterol, high levels of low density lipoprotein-cholesterol, high aspartate aminotransferase levels, high alanine aminotransferase levels, and hyperuricemia were all associated with NAFLD, and all of these measures reached statistical significance (p＜0.001). The subjects with negative anti-hepatitis C antibody titers had features of NAFLD (p=0.044). The result of a stepwise multivariate logistic regression model revealed that age (Odds Ratio [OR]=1.1; 95% confidence interval [CI] 1.0-1.1), central obesity (OR=4.2; 95% CI 2.8-6.4), impaired fasting glucose or diabetes mellitus (OR=2.3; 95% CI 1.3-4.0), hypertriglyceridemia (OR=2.5; 95% CI 1.7-3.7) and high alanine aminotransferase (OR=2.6; 95% CI 1.6-4.2) were more commonly associated with NAFLD. However, subjects with hepatitis C virus infection weren't predisposed to NAFLD (OR=0.2; 95% CI 0.1-0.7). In conclusion, physicians should consider the possibility of NAFLD, if patients are elderly, have central obesity, impaired fasting glucose or diabetes mellitus, high triglyceride levels, high alanine aminotransferase levels, and negative anti-hepatitis C antibody titers.

並列關鍵字

non-alcoholic fatty liver disease ； waist circumference ； alanine aminotransferase ； triglyceride ； hepatitis C virus

參考文獻

陳進明、廖浩欽、王豐林、李強忠、林忠順(2003)。脂肪肝有無併肝生化異常相關因子之探討－以某醫學中心勞工健檢結果為例。台灣家醫誌。13，53-60。

Adinolf LE,Utili R,Andreana A(2004).Serum HCV RNA levels correlate with histological liver damage and concur with steatosis in progression of chronic hepatitis C.Dig Dis Sci.46,1677.

Angulo P,Lindor KD(2002).Non-alcoholic fatty liver disease.J Gastroenterol Hepatol.17,186-190.

Anonymous(2001).Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).JAMA.285,2486-2497.

C-F Jan,C-J Chen,Y-H Chiu(2006).A population-based study investigating the association between metabolic syndrome and Hepatitis B/C infection (Keelung Community-based Integrated Screening Study No. 10).Int J Obes.30,794-799.