非酒精性脂肪性肝病患者血清尿酸、血糖与冠心病的关系

doi:10.3969/j.issn.1006-5253.2020.06.005

摘要
图/表
参考文献
相关文章 (14)

全文: PDF (1030 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要

目的分析非酒精性脂肪性肝病(NAFLD)患者血清尿酸、血糖与冠心病的关系。方法收集2016年1月至12月我院收治行冠脉造影的NAFLD患者，最终纳入219例。使用超声或CT检查诊断是否患有脂肪肝。采用logistic多因素回归分析影响冠脉病变的因素。结果在所有的NAFLD患者中，非冠心病患者62例，NAFLD合并冠心病患者157例。NAFLD合并冠心病患者的ALT、AST、GGT、Cr、SUA、GLU升高，HDL降低，差异均有统计学意义。多因素logistic回归分析显示，男性（OR=2.296，95%CI：1.153～4.572）、血糖升高（OR=1.426，95%CI：1.077～1.887）、血清尿酸升高（OR=1.005，95%CI：1.001～1.009），冠心病的危险程度增加。结论在NAFLD合并冠心病的患者中，及时了解其发生的危险因素，控制好血糖及血清尿酸水平，加强干预，降低冠心病的发生率。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王晓晗
	沈亮
	陈云清
	沈月玉
	高晨
	侯震涛
	韩丰
	冀子中

关键词 ：非酒精性脂肪性肝病, 冠心病, 血清尿酸, 血糖

Abstract：

Objective To analyze the relationship between serum uricemia, blood glucose and coronary heart disease in patients with nonalcoholic fatty liver disease (NAFLD). Methods Two hundred and nineteen NAFLD patients with coronary angiography admitted to our hospital from January 2016 to December 2016 were enrolled. Ultrasound or CT examination was used to diagnose fatty liver. Factors affecting coronary artery disease were analyzed by Logistic multivariate regression. Results Among all NAFLD patients, 62 were nonCHD patients and 157 were NAFLD patients with CHD. In NAFLD patients with coronary heart disease, ALT, AST, GGT, Cr, SUA and GLU increased and HDL decreased compared with NAFLD patients, and the differences were statistically significant. Multivariate Logistic regression analysis showed that increased risk of coronary heart disease was associated with blood glucose (OR=1.426, 95%CI:1.077-1.887) and serum uric acid (OR=1.005，95%CI:1.001-1.009) in males(OR=2.296, 95%CI: 1.153-4.572). Conclusion In patients with NAFLD complicated with coronary heart disease, it is necessary to timely understand the risk factors, control blood glucose level and serum uric acid level, strengthen intervention, and reduce the incidence of coronary heart disease.

Key words： nonalcoholic fatty liver disease coronary heart disease serum uric acid blood glucose

收稿日期: 2020-06-28

基金资助:嘉兴市科技计划项目(2018AD32096)；
浙江省医药卫生科技计划项目(2018KY798)；
嘉兴市第一医院优秀青年基金(2018-GG-10)；
嘉兴市第一医院市级医学重点学科项目(2019-zc-08)

通讯作者: 王晓晗，Email：853706741@qq.com

引用本文:

王晓晗，沈亮，陈云清，沈月玉，高晨，侯震涛，韩丰，冀子中. 非酒精性脂肪性肝病患者血清尿酸、血糖与冠心病的关系[J]. 中国医院统计, 2020, 27(6): 494-497.
Wang Xiaohan, Shen Liang, Chen Yunqing, Shen Yueyu, Gao Chen, Hou Zhentao, Han Feng, Ji Zizhong. Relationship between serum uricemic, blood glucose and coronary heart disease in patients with nonalcoholic fatty liver disease. journal1, 2020, 27(6): 494-497.

链接本文:

http://manu58.magtech.com.cn/Jwk_zgyytj/CN/10.3969/j.issn.1006-5253.2020.06.005 或 http://manu58.magtech.com.cn/Jwk_zgyytj/CN/Y2020/V27/I6/494

［1］MANGI M A, REHMAN H, MINHAS A M, et al. Non-alcoholic fatty liver disease association with cardiac arrhythmias［J］. Cureus, 2017, 9(4):e1165. DOI:10.7759/cureus.1165.
［2］SAMJI N S, HEDA R, SATAPATHY S K. Peri-transplant management of nonalcoholic fatty liver disease in liver transplant candidates?［J］. Transl Gastroenterol Hepatol, 2020, 5:10.
［3］MARCHESINI G, BRIZI M, BIANCHI G, et al. Nonalcoholic fatty liver disease: A feature of the metabolic syndrome［J］. Diabetes, 2001, 50(8):1844-1850.
［4］MARCHESINI G, BUGIANESI E, FORLANI G, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome［J］. Hepatol Baltim Md, 2003, 37(4):917-923.
［5］WANG P, QIANG H, SONG Y, et al. Association between nonalcoholic fatty liver and gensini score in patients with coronary heart disease: A crosssectional study［J］. Cardiology, 2019, 144(3/4):90-96.
［6］LI C Y, CHEN J, SHI X F. Associations of non-alcoholic fatty liver disease with prevalence, severity, and prognosis of coronary heart disease［J］. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 2019, 41(2):156-161.
［7］WANG B, LI F, GUO J J, et al. Effects of liver function, insulin resistance and inflammatory factors on vascular endothelial dilation function and prognosis of coronary heart disease patients complicated with NAFLD［J］. Exp Ther Med, 2019, 17(2):1306-1311.
［8］NDREPEPA G. Uric acid and cardiovascular disease［J］. Clin Chimica Acta; Int J Clin Chem, 2018, 484:150-163.
［9］LABENZ C, HUBER Y, MICHEL M, et al. Impact of NAFLD on the incidence of cardiovascular diseases in a primary care population in Germany［J］. Dig Dis Sci, 2020, 65(7):2112-2119.

［10］WU R N, HOU F, WANG X M, et al. Nonalcoholic fatty liver disease and coronary artery calcification in a northern Chinese population: A cross sectional study［J］. Sci Rep, 2017, 7(1):9933.
［11］ZHANG Y W, XU J, WANG X M, et al. Changes of intestinal bacterial microbiota in coronary heart disease complicated with nonalcoholic fatty liver disease［J］. BMC Genomics, 2019, 20(1):862.
［12］SONG Y, DANG Y, WANG P, et al. CHD is associated with higher grades of NAFLD predicted by liver stiffness［J］. J Clin Gastroenterol, 2020, 54(3):271-277.
［13］周学敏,朱国斌,黄淑田,等.高尿酸与冠状动脉严重程度及支架置入后的预后相关性［J］.中华临床医师杂志(电子版),2016,19：2842-2846.
［14］王素芹，田华，孙晓凤，等．二分类logistic 回归在冠心病危险因素研究中的应用［J］．中国医院统计，2014，21(2)：81-84.
［15］张秀红, 刘淑婧, 张铭. 高尿酸血症与冠心病关系的初探［J］. 疾病监测与控制杂志, 2019, 3：220-228.
［16］DAMASKOS C, GARMPIS N, KOLLIA P, et al. Assessing Cardiovascular Risk in Patients with Diabetes: An Update ［J］. Curr Cardiol Rev, 2019.
［17］VREMAN R A, GOODELL A J, RODRIGUEZ L A, et al. Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: A microsimulation model［J］. BMJ Open, 2017, 7(8):e013543.
［18］BROUHA S S, NGUYEN P, BETTENCOURT R, et al. Increased severity of liver fat content and liver fibrosis in non-alcoholic fatty liver disease correlate with epicardial fat volume in type 2 diabetes: A prospective study［J］. Eur Radiol, 2018, 28(4):1345-1355. 
［19］张琪,刘凌翀,李桂杰,等.Logistic模型预测冠状动脉狭窄程度［J］.中国医院统计,2017,24(2):105-107.
［20］LINGE J, WHITCHER B, BORGA M, et al. Subphenotyping metabolic disorders using body composition: An individualized, nonparametric approach utilizing large data sets［J］. Obesity (Silver Spring), 2019, 27(7):1190-1199. 
［21］MANTOVANI A, BALLESTRI S, LONARDO A, et al. Cardiovascular disease and myocardial abnormalities in nonalcoholic fatty liver disease［J］. Dig Dis Sci, 2016, 61(5):1246-1267.