【摘要】：目的:了解桂林市漢族體檢人群非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的患病率、分布特征及相關危險因素,探討脂聯(lián)素基因啟動子區(qū)-11377C/G單核苷酸多態(tài)性與NAFLD的相關性。方法:采用整群抽樣方法,選擇6660名體檢者為研究對象,進行橫斷面調查,內容涉及問卷調查,測量身高、體重、血壓,檢測丙氨酸氨基轉移酶(alanine aminotransferase,ALT)、天門冬氨酸氨基轉移酶(aspartate aminotransferase,AST)、空腹血糖(fasting plasma glucose,FPG)、甘油三酯(triglyceride,TG)、總膽固醇(total cholesterol,TC)、高密度脂蛋白膽固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白膽固醇(low-density lipoprotein cholesterol,LDL-C)、尿酸(uric acid,UA)及肝臟超聲檢查,并計算體重指數(shù)(body mass index,BMI)。應用聚合酶鏈式反應-限制性片段長度多態(tài)性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)法檢測260例研究對象(NAFLD組130例,對照組130例)的脂聯(lián)素基因啟動子區(qū)-11377C/G單核苷酸多態(tài)性。結果:(1)桂林市6660例漢族體檢人群中,NAFLD患病粗率為19.1%,全國人口標化率為16.9%(男性24.8%,標化后23.4%;女性12.9%,標化后10.1%)。50歲之前男性NAFLD患病率顯著高于女性,而70歲之后顯著低于女性,男女性NAFLD患病率的年齡交叉點在50-69歲中老年階段。(2)NAFLD患病率隨BMI增加呈升高趨勢,無論男性或女性,超重和肥胖組NAFLD患病率顯著高于正常組(P0.01),且肥胖組NAFLD患病率顯著高于超重組(P0.01)。(3)共檢出NAFLD 1273例(男性862例,女性411例),同時選取年齡與性別相匹配的健康人群1273例(男性862例,女性411例)為對照組,分析兩組臨床資料。NAFLD組BMI、收縮壓(systolic blood pressure,SBP)、舒張壓(diastolic blood pressure,DBP)、ALT、AST、FPG、TG、TC、LDL-C、UA水平均高于對照組(P0.01),HDL-C低于對照組(P0.01)。(4)Logistic回歸分析顯示:性別(男)、BMI、高血壓、ALT、FPG、TG、LDL-C、UA均為NAFLD危險因素,HDL-C為NAFLD保護因素。(5)脂聯(lián)素基因啟動子區(qū)-11377C/G單核苷酸多態(tài)性分析:NAFLD組與對照組基因型(CC:59.2%vs 63.8%,CG:36.2%vs 30.8%,GG:4.6%vs 5.4%)和等位基因頻率(C:77.3%vs 79.2%,G:22.7%vs 20.8%)分布差異均無統(tǒng)計學意義(P0.05)。兩組脂聯(lián)素基因-11377C/G不同基因型與臨床變量比較,差異均無統(tǒng)計學意義(P0.05)。結論:(1)桂林市漢族體檢人群中有相當比例個體患有NAFLD,并存在年輕化趨勢,且NAFLD患病率隨BMI增加呈升高趨勢。(2)NAFLD人群與代謝綜合征(metabolic syndrome,MS)各組分密切相關。(3)性別(男)、BMI、高血壓、ALT、FPG、TG、LDL-C、UA均為NAFLD危險因素,HDL-C為NAFLD保護因素。(4)脂聯(lián)素基因啟動子區(qū)-11377C/G單核苷酸多態(tài)性與桂林市漢族體檢人群NAFLD發(fā)病無明顯相關性。
[Abstract]:Objective: to investigate the prevalence, distribution and risk factors of non-alcoholic fatty liver (nonalcoholic fatty liver disease,NAFLD) in Han nationality in Guilin, and to explore the relationship between 11377C/G single nucleotide polymorphism and NAFLD in the promoter region of adiponectin gene. Methods: a cross-sectional survey was carried out in 6660 subjects by cluster sampling, including questionnaire survey, measurement of height, weight, blood pressure, and detection of alanine aminotransferase (alanine aminotransferase,ALT). Aspartate aminotransferase (aspartate aminotransferase,AST), fasting blood glucose (fasting plasma glucose,FPG), triglyceride (triglyceride,TG), total cholesterol (total cholesterol,TC), high density lipoprotein cholesterol (high-density lipoprotein cholesterol,HDL-C), Low density lipoprotein cholesterol (low-density lipoprotein cholesterol,LDL-C), uric acid (uric acid,UA), liver ultrasound and body mass index (body mass index,BMI) were calculated. Polymerase chain reaction-restriction fragment length polymorphism (polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP) was used to detect the single nucleotide polymorphisms of adiponectin gene promoter region (11377C/G) in 260 subjects (NAFLD group, 130 cases, control group, 130 cases). Results: (1) in 6660 Han people in Guilin, the crude rate of NAFLD was 19.1%, and the standardized rate of population was 16.9% (male 24.8, 23.4% after standardization); The prevalence of NAFLD in males before the age of 50 was significantly higher than that in females, and after 70 years of age, it was significantly lower in males than in females. (2) the prevalence of NAFLD increased with the increase of BMI. The prevalence rate of NAFLD in overweight and obesity group was significantly higher than that in normal group (P0.01), regardless of whether male or female, the prevalence rate of NAFLD was significantly higher in overweight and obese group than in normal group (P0.01). The prevalence of NAFLD in obese group was significantly higher than that in overweight group (P0.01). (3). 1273 cases of NAFLD were detected (male 862, female 411), and 1273 healthy persons (male 862, female 411) matched age and sex were selected as control group. The levels of BMI, systolic blood pressure (systolic blood pressure,SBP), diastolic blood pressure (diastolic blood pressure,DBP) and ALT,AST,FPG,TG,TC,LDL-C,UA in NAFLD group were higher than those in control group (P0.01). HDL-C was lower than the control group (P0.01). (4) Logistic regression analysis showed that sex (male), BMI, hypertension, ALT,FPG,TG,LDL-C,UA were all NAFLD risk factors) (5) single nucleotide polymorphism analysis of adiponectin gene promoter region-11377C/G: CC:59.2%vs group and control group (CC:59.2%vs 63.8G: 36.2 vs 30.8). There was no significant difference in the distribution of GG:4.6%vs 5.4% and allele frequency (C:77.3%vs 79.2g: 22.7vs 20.8%) (P0.05). There was no significant difference in adiponectin gene 11377C/G genotypes and clinical variables between the two groups (P0.05). Conclusion: (1) there is a significant proportion of individuals with NAFLD, in Guilin Han population, and the prevalence rate of NAFLD increases with the increase of BMI. (2) NAFLD population and metabolic syndrome (metabolic syndrome,. (3) Sex (male), BMI, hypertension, ALT,FPG,TG,LDL-C,UA were all risk factors of NAFLD). (4) 11377C/G single nucleotide polymorphisms in the promoter region of adiponectin gene had no significant correlation with the incidence of NAFLD in healthy population of Han nationality in Guilin.
【學位授予單位】：桂林醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R575.5

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