An Analysis Of Risk Factors For Nonalcoholic Fatty Liver Disease Combined With Gallstone Disease In Middle- Aged And Elderly People

Objective:To investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) among retired workers in Gulou district of Nanjing, and to explore the risk factors of NAFLD combined with GD.Method:The survey was conducted among 3926 retired workers of Gulou district in medical examination center in the Second Hospital of Nanjing, from March 2012 to June 2013. The main content of the research include:general situation (the Past medical history, smoking, drinking, diet and exercise lifestyle); physical examination (height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP)); biochemical examination (blood glucose, uric acid, liver function, blood lipids); abdominal ultrasound were included in this study. We excluded subjects with the following conditions:autoimmune liver disease, alcoholic liver disease, viral liver disease, drug-induced liver disease, malignant tumor diseases, and incomplete information. A total of 9051 subjects were enrolled for the final analyses, which were divided into the group of NAFLD without GD, the group of NAFLD combined with GD, without NAFLD as the control group. The characteristic and related risk factors of the subjects were collected.Results:1. The basic situation of the survey crowdA total of 9051 subjects, age (50-93), the average age of (63.72±9.41) years old, the male 1132 cases, the female 1919 cases, the ratio of male and female was 1:1.7.There were 1117 patients with NAFLD, the detection rates was 36.62%; 598 patients with GD, the detection rates was 19.60%; 264 patients with NAFLD combined with GD, the detection rates was 8.65%, the male/the female (79/185), the NAFLD combined with GD of detection rates in male is lower than in female (6.98%/9.64%), Prevalence of men and women have significant difference (P<0.05). The incidence of GD in the NAFLD group was significantly higher than in the normal population (23.63% /17.27%, P< 0.01).2. Clinical information of the three groupsAmong the three groups, the distributions of the gender, smoking status, dietary habit, the usual frequency of exercise, hypertension, diabetes mellitus, age, body mass index (BMI), diastolic blood pressure (DBP), ALT, AST, fasting blood glucose (FBG), uric acid (UA), triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were significant different (P<0.05). For NAFLD combined with GD and without GD, the gender, smoking status, hypertension, diabetes, age, AST and TC were significant different (P < 0.05). In the group of the NAFLD with GD, the detection rates showed an increase trend with the age increasing in the female subjects, while not in the male subjects (trend test analysis, P<0.05).The prevalence of hypertension, hyperglycemia, overweight or obese the group of the NAFLD combined with GD, were significant higher than the group of the NAFLD without GD (P<0.05), but the prevalence of hyperuricemia, abnormal transaminase, dyslipidemia and abnormal blood lipid were no significant different in the groups with or without GD (P>0.05). Among the three groups, the prevalence of the metabolic syndrome were significant different (P<0.05). But the prevalence of the metabolic syndrome were no significant different between the group of the NAFLD without GD and with GD (P>0.05).3. Risks of NAFLD combined with GD by Logistic regression analysisBy the binary classification unconditioned Logistic regression analysis, the results showed that the female, frequent exercising, smoking, hypertension, age (55 to 59,60-69,70-79 years old), ALT, GGT, FBG, UA, TG, HDL-C and LDL-C into the regression equation, the difference was statistically significant (P<0.05) in the group NAFLD with GD compared with the control group; By comparison in the group NAFLD with GD and without GD, the female, occasional exercise, hypertension and age (55 to 59,60-69,70-79,80 aged years Or older) into the regression equation (P<0.05), were risk factors of NAFLD combined with GD, the OR respectively were 2.448,3.090,1.368,2.535,2.630,6.414,2.630.Conclusion:There was higher prevalence of GD in the NAFLD population than without NAFLD population. The NAFLD population with the elderly, the female, hypertension, diabetes mellitus or high blood glucose, overweight or obese, less smoking, high levers of AST and low levers of TC were more likely to be merged with GD. The female, regular exercise, hypertension and the elderly, were risk factors of NAFLD combined with GD. Aimed at the older women, proper comprehensive measures such as blood pressure, blood glucose, blood lipid and body weight should be controlled, the usual frequency of exercise should be strengthened, then preventing the development of NAFLD combined with GD.