| Objective: To investigate the prevalence and distribution of NAFLD among the Tianjin health check-up population, and evaluate the relationship of NAFLD with the indicators of the blood lipid content, abdominal fat area, and abdominal fat tissues volume, and explore the risk factors for NAFLD.Methods: With cross-sectional study and case control study, total of 7835 subjects who took physical examination during May 1 in 2013 to May 1 in 2014 in Tianjin First Central Hospital were recruited and screened on NAFLD. Then, according to the diagnosis cretiria of NAFLD made by Chinese Society of Medical Science in 2010 as well as the results of B ultrasound, 180 patients with NAFLD and 180 normal controls were random selected for the case-control study. Date, collected from selfdesigned questionnaire, laboratory testing and physical examination, were analyzed with univariate logistic regression and unconditional logistic regression analysis on factors associated with NAFLD.Results:1. The prevalence of NAFLD was 27.3%(standardized rate was 25.4%), 33.7% for male and 16.6% for female, by cross-sectional study. The NAFLD prevalence of female was rising with age and lower than those of male during age 20 to 50 yrs old, but significantly higher than that of male after 60 yrs old(all p<0.05).The rates of overweight/obesity, T2 DM, hypertension, hyperuricemia, hyperlipidemia, abnormal liver function, family hypertension, family diabetes and family cardiovascular disease(CVD) were all higher in NAFLD group than in the normal control group, There were 87.7% patients with different complications, the most common one was overweight/obesity(87.18%). 2. With the principal component transformational logistic regression analysis, the results showed that risk factors for NAFLD including: sedentary time longer(OR=1.845),mainly refined grains taking(OR= 3.020), more red meat taking(OR=1.878), hypertension(OR=2.258), hyperuricemia(OR=2.670),the overweight length(OR=1.433),higher body mass index(BMI)(OR=2.070),higher viscera obesity(OR=2.650),higher abdominal subcutaneous obesity(OR=2.111). Protective factors for NAFLD was exercise time more than 2 hours per week(OR=0.565). 3. Results from interaction analysis showed that the indicators of sedentary time longer and exercise time shorter [RERI=5.57(1.13-9.99), AP=0.64(0.42-0.87), S=3.67(1.49-8.97)], hyperuricemia and exercise time shorter [RERI=9.91(3.28-23.10), AP=0.78(0.15-0.75),S=4.94(1.05-3.41)], more refined grains taking and higher viscera fat area [RERI=56.89(16.31-130.1),AP=0.77(0.54-1.01),S= 4.65(1.57-13.81)], higher BMI and higher viscera fat area [RERI=47.58(13.15-108.3), AP=0.81(0.60-1.03), S=5.82(1.78-19.02)], higher viscera fat area and higher abdominal subcutaneous volume [RERI=41.78(13.20-96.77), AP=0.81(0.72-0.91), S=5.81(3.69-9.16)] had synergistic effects on NAFLD incidence.Conclusion:1.The level of NAFLD among the studied health check-up population was higher than that of the national wide. The distribution of NAFLD among patients in each ages groups was different; Considering most of them were complicated with other chronic diseases or at unhealthy state, while lots of factors, including foods pattern, life-style and fat distribution, were related to NAFLD, so it is suggested to take active measures and actively lifestyle changes to prevent the happening of the NAFLD. 2. According to the diagnostic test and unconditioned Logistic regression analysis, abdominal viscera fat area and abdominal subcutaneous fat volume were independent risk factors for the development of NAFLD and visceral fat area was more likely to increase the risk of NAFLD incidence, Interaction analysis showed abdominal viscera fat area and abdominal subcutaneous fat volume have synergistic effect to NAFLD incidence. So, it is suggested to take viscera fat area measured by the body composition analyzer and abdominal subcutaneous fat volume by B ultrasound in order to improve the ability of NAFLD screening among the physical examination population. |
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