热带海岛环境作业人员罹患代谢相关脂肪性肝病情况及与代谢性组分之间的相关性
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上海市青年科技英才扬帆计划(21YF1458800),军队护理创新与培育专项计划(2021HL029).


Prevalence of metabolic associated fatty liver disease and its correlation with metabolic components in personnel on tropical islands
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Supported by Yangfan Plan of Young Science and Technology Talents of Shanghai (21YF1458800) and Military Nursing Innovation and Cultivation Project (2021HL029).

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    摘要:

    目的 调查热带海岛作业人员的代谢相关脂肪性肝病(MAFLD)患病率及其与代谢性组分之间的相关性。方法 分析2024年度海岛作业人员的健康体检资料,以30岁为界限分组比较不同年龄段人群MAFLD及代谢性组分的检出率。在年龄≥30岁人群中,比较MAFLD患者与无MAFLD对照之间年龄、性别、BMI、腰围、空腹血糖、血脂、肝功能、肾功能等指标,采用单因素与多因素logistic回归模型分析影响MAFLD发生的因素。通过亚组分析探究各种代谢性组分对不同年龄段人群MAFLD发生风险的影响。结果 1 213名作业人员中MAFLD患者175例(14.4%),其中轻度141例(80.6%)、中度32例(18.3%)、重度2例(1.1%);按照年龄分组,年龄≥30岁组的MAFLD检出率[25.6%(74/289) vs 10.9%(101/924)]、超重/肥胖检出率[55.7%(161/289) vs 37.7%(348/924)]均高于年龄<30岁组(均P<0.001)。在年龄≥30岁人群中,与无MAFLD对照相比,MAFLD患者的BMI、腰围、收缩压、舒张压、甘油三酯、低密度脂蛋白胆固醇、丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶、尿酸均较高(均P<0.05),高密度脂蛋白胆固醇(HDL-C)较低(P<0.05),年龄、性别、空腹血糖、总胆固醇、碱性磷酸酶、总胆红素、血肌酐、血尿素氮差异均无统计学意义(均P>0.05);logistic回归分析显示,腰围是MAFLD发生的独立危险因素(OR=1.101,95%CI 1.030~1.176,P=0.004),HDL-C是预防MAFLD发生的独立保护因素(OR=0.071,95%CI 0.016~0.323,P=0.001),BMI≥24.0 kg/m2、腰围≥90 cm均与MAFLD呈独立正相关(均P<0.01)。在年龄≥30岁人群中,超重/肥胖、动脉血压≥130/85 mmHg(1 mmHg=0.133 kPa)、甘油三酯≥1.7 mmol/L、HDL-C≤1.0 mmol/L及尿酸>420 μmol/L者MAFLD患病风险升高(均P<0.05),其中超重/肥胖人群MAFLD患病风险升高最为显著(HR=5.088,95%CI 2.724~9.504,P<0.001)。在年龄<30岁人群中,超重/肥胖、尿酸>420 μmol/L者MAFLD患病风险升高(均P<0.01),其中超重/肥胖人群MAFLD患病风险升高最为显著(HR=6.305,95%CI 3.973~10.006,P<0.001)。结论 热带海岛作业人员中MAFLD与各种代谢性组分的检出率较高,合并超重/肥胖、甘油三酯≥1.7 mmol/L、高尿酸血症者MAFLD的发生风险升高。

    Abstract:

    Objective To investigate the prevalence of metabolic associated fatty liver disease (MAFLD) and its correlation with metabolic components among personnel on tropical islands. Methods The data of personnel who received health examination on islands in 2024 were analyzed, and they were grouped with the age limit of 30 years old to compare the detection rates of MAFLD and metabolic components in different age groups. In people aged≥30 years old, the age, gender, body mass index (BMI), waist circumference (WC), fasting blood glucose, blood lipids, liver function, kidney function and other indexes were compared between MAFLD and non-MAFLD groups. Univariate and multivariate logistic regression models were conducted to analyze the factors affecting the occurrence of MAFLD. The effects of various metabolic components on the risk of MAFLD in different age groups were analyzed by subgroup analyses. Results Among 1 213 personnel, 175 (14.4%) cases had MAFLD, of which 141 (80.6%) cases were mild, 32 (18.3%) were moderate, and 2 (1.1%) were severe. The detection rates of MAFLD (25.6% [74/289] vs 10.9% [101/924]) and overweight/obesity (55.7% [161/289] vs 37.7% [348/924]) in age≥30 years old were significantly higher than those in age<30 years old (both P<0.001). In people aged≥30 years old, compared with the non-MAFLD group, the BMI, WC, systolic blood pressure, diastolic blood pressure, triglyceride (TG), low density lipoprotein-cholesterol, alanine transaminase, aspartate transaminase, gamma glutamyltransferase and uric acid (UA) in the MAFLD group were significantly higher (all P<0.05), and the high density lipoprotein-cholesterol (HDL-C) was significantly lower (P< 0.05). There were no significant differences in age, gender, fast blood glucose, total cholesterol, alkaline phosphatase, total bilirubin, serum creatinine, or blood urea nitrogen (all P>0.05). Logistic regression analysis showed that WC was an independent risk factor for MAFLD (odds ratio [OR] =1.101, 95% confidence interval [95%CI] 1.030-1.176, P=0.004); HDL-C was an independent protective factor for MAFLD (OR=0.071, 95%CI 0.016-0.323, P=0.001); and BMI≥24.0 kg/m2 and WC≥90 cm were positively correlated with MAFLD (both P<0.01). In people aged≥30 years old, the risk of MAFLD was increased in those with overweight/obesity, arterial blood pressure≥130/85 mmHg (1 mmHg=0.133 kPa), TG≥ 1.7 mmol/L, HDL-C≤1.0 mmol/L and UA>420 μmol/L (all P<0.05), and the risk of MAFLD was most significantly increased in overweight/obesity people (hazard ratio [HR] =5.088, 95%CI 2.724-9.504, P<0.001). Among people aged< 30 years old, the risk of MAFLD was increased in those with overweight/obesity and UA>420 μmol/L (both P<0.01), and the risk of MAFLD was most significantly increased in overweight/obesity individuals (HR=6.305, 95%CI 3.973-10.006, P< 0.001). Conclusion The detection rates of MAFLD and various metabolic components are higher in the personnel on tropical islands, and the risk of MAFLD is higher in those with overweight/obesity, TG≥1.7 mmol/L and hyperuricemia.

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  • 收稿日期:2024-07-10
  • 最后修改日期:2024-12-17
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  • 在线发布日期: 2025-08-19
  • 出版日期: 2025-08-20
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