The Epidemic Investigation Of Non-Alcoholic Fatty Liver And The Significance Of Detecting The Supersensitive C-reactive Protein

Fatty liver is a pathological conception.It is a clinical pathological syndrome performed as the excessive accumulation of fat caused by many diseases and other factors. If the contents of fat exceeds 50%of the liver humid weight or the LB(liver biopsy) or more than 30%of the liver cells have fatty degeneration and diffuse in the whole liver,then it called Fatty liver,which includes Simple Fatty liver,Fatty hepatitis and Fatty hepatic cirrhosis in pathology.In clinic,it can be divided into Alcoholic fatty liver and Non-Alcoholic fatty liver according to the drinking history of patients(NAFLD).NAFLD includes Simple Fatty liver and Fatty hepatitis.Some Non- Alcoholic Fatty hepatitis (NASH) can develop into hepatic fibrosis,hepatic cirrhosis and the terminal stage of the liver trouble.With the rapid progress of economy,there are dramatic changes in people's diet structure and life-style.The pathogenies of fatty liver vary accordingly.Before 1960s,the major reason for Fatty liver had been the lack of nutrition such as malignant malnutrition. Since 1980s,however,the major reasons are surplus nutrition fatness,excessive drinking, diabetes and hepatic lesion by drugs.And NAFLD has replaced the Alcoholic fatty liver as the dominant cause of the liver disease.LB(liver biopsy) is a gold standard for the diagnosis of Fatty liver.But the Fatty liver has caught the clinical attention mainly as the imageology diagnosis.The epidemiology study of Fatty liver has aroused a lot of concern.The Fatty liver attack rate of the average adults in the western countries has reached 20%from 10%in 1980s.Fatness,diabetes and alcoholism are the leading causes.There is a big difference with Fatty liver attack rate in our country.For example,it is 19.29%in Daqing,17.29%in Shanghai,and 13.20%in Guangzhou. While many scholars have been dedicated to the research for the pathogeny leading to Fatty liver,the pathogeny and pathogenesis of the fatty liver remain unknown with the multiple factors and dangerous factors involved.This research uses the T-sect methods to analyze the patients of NAFLD,providing some tentative suggestions for the diagnosis, prevention and treatments of NAFLD and laying a foundation for further analytical research and the experimental research.Results of SectionⅠ1.Subjects and methodsIn this work,epidemiologic survey was used to conduct a cross-sectional study.The subjects,4191 staff members of Changsha Railroad Station received physical check-up the Changsha City No.7 Hospital,China.The general clinical data were acquired by questionnaire,and the physical examination included contractive pressure,diastolic pressure,body height,body mass,waistline and hip circumstance,etc.Blood test included TG,CHO,HDL,LDL,FBS,ALT,AST,BUN,Cr,UA,TBIL,HBsAg,Anti-HBs,HBeAg, Anti-HBe,Anti-HBc.Ultrasonograph test of pancreas,lien,and both kidneys,prostate, hystera and also electrocardiography were conducted.All the data were processed by SPSS 10.0 packages.Chi-Square Test or Pearson Chi-Square was used to compare the 2-set or multi-set numeration data,respectively,and all the measurement data were represented in MEAN±SD,and unpaired t-test was used to compare the measurement data.Binary Logistic regression analysis and Bivariate dependability analysis were used to evaluate the related factors of NAFLD.2.ResultsAmong the 3872 subjects,who had complete data and criteria,are 1005 cases(25.96%) of fatty liver disease,of which NAFLD was 872 cases(22.52%)。2.1 Comparison of the subjects with normal control groupCompared to the normal control group,the biochemical indicators of NAFLD cases were significantly different from that of the control(P＜0.01),except the TBIL level(P＞0.05).2.2 Comparison of the subjects with the group without fatty liver diseaseExcluding hepatitis and alcoholic fatty liver from the 3872 cases,among the 3451 cases,the NAFLD incidence in males(22.08%)was significantly higher than that of females (3.19%).Regardless of gender,the incidence was at the peak among people in their 40s or 50s and decreased in patients over 60 years-old.Based on the Ultrosonograph,the patients were grouped in two,i.e.,NAFLD group(872 patients) and non-FLD group(2579 patients). Comparison between the two groups showes that there were no differences in BUN,and there was obvious difference in TBIL(P＜0.05),and significant difference in the other indexes(P＜0.01).The HDL level of NAFLD group obviously decreased compared with that of non-FLD group,but the others in NAFLD were all higher than that of non-FLD group.Prevalence of abnormal levels in the two groups were found as,except BUN,Cr,TBIL(P＞0.05),all the others were significantly different(P＜0.01),and in NAFLD group,BMI,WHR and TG were the first 3 highest,with the incidence of 72.48%, 66.97%and 68.81%respectively.The incidence of BUN and Cr were low and there was no significant difference.2.3 Comparison by ALTBased on ALT level,the 3451 cases were grouped as normal(ALT≤40U/L) and abnormal(＞40U/L).All indexes except age showed significant difference(P＜0.01).In order to compare incidence of abnormal ALT level,other indexes were also used to group the 3451 cases(BMI based on obesity criterion,WHR,hs-CRP and IR based on groups of quartering position,and the results showed that incidence of abnormal ALT level increased with elevated BMI,WHR,hs-CRP and IR levels.2.4 Binary Logistic regression analysisBinary Logistic regression analysis was conducted according to the indexes of the 3451 cases.The findings showed that the final selected indexes in order were BMI,ALT, WHR,TG,DBP,FBS,UA,gender and age,excluding SBP,CHO,LDL,AST and TBIL. However,ALT should be considered as a result of NAFLD,instead of a risk factor。Thus, the first 3 indexes most related to NAFLD should be BMI,WHR and TG.Though SBP and cholesterol were not selected,the relation between them and NAFLD remained unconfirmed.2.5 Analysis about the 872 NAFLD patientsComparison of serum indexes in different gender NAFLD cases showed that there was statistical significance in the differences in DBP,WHR,TG,HDL,UA and ALT levels(P＜0.01),with obvious differences in TBIL(P＜0.05) but no significant difference in others between the two groups.Regardless of gender,BMI of most of cases were in 25-29 Kg/m~2, and 74.3%males and 58.2%females had BMI of more than 25 Kg/m~2。Results of the SectionⅡ400 cases were randomly selected from the 3451 subjects and grouped as NAFLD group(195 cases) and control group(205 cases).Comparison between the two groups showed that,the HOMA-IR and hs-CRP levels in NAFLD group were significantly higher than that of the control group(P＜0.01).Bivariate analysis showed normal correlation between HOMA-IR and hs-CRP,although correlation coefficient is small(r=0.431,P＜0.01).3.ConclusionThe study revealed that the staff members of Changsha Railway Station,China suffered from high incidence of NAFLD.And the incidence of the disease among males is higher than that among females.Regardless of gender,the incidence was at the peak among people in their 40s or 59s,but decreased in patients over 60 years-old.BMI,WHR,TG are the first 3 leading risk factors of NAFLD,and ALT level maybe a important indictor for NAFLD screening,and increased hs-CRP may be related with NAFLD.