Analysis Of Clinical Features And Identification Of Risk Factors Of Nonalcoholic Fatty Liver Disease In Changchun

Objective:To explore and analyse the clinical features of nonalcoholic fatty liver disease(NAFLD)in Changchun,and select its affecting factors and independent risk factors.Hoping to strengthen the clinicians' understanding of NAFLD and achieve its early diagnosis and treatment,in order to reduce the further development and related complications of NAFLD.Methods:According to NAFLD diagnostic criteria,based on liver elastic transient imaging technology,FibroTouch was used to screen the population who first visited the physical examination Center of the second Hospital of Jilin University between August 2015 and September 2018.A total of 2179 cases who underwent FibroTouch examination and had complete clinical data were sorted out and collected.Among them,1056 patients with NAFLD as observation group and 1123 people without NAFLD as control group(non-NAFLD group).NAFLD group were divided into mild,moderate and severe fatty liver groups according to controlled attenuation parameters(CAP)value.The sex,age,height,body weight,body mass index(BMI),CAP value,liver stiffness(LSM),Alanine amino transferase(ALT),aspartate amino transferase(AST),gamma glutamyl transpeptidase(?-GGT),alkaline phosphatase(ALP),total bilirubin(TBIL),triglyceride(TG),Total cholesterol(TC),Low density lipoprotein cholesterol(LDL-C),High density lipoprotein cholesterol(HDL-C),Serum uric acid(SUA),Serum Screatinine(Scr),Blood urea nitroqen(BUN),Fasting plasma glucose(FPG),Helicobacter pylori(HP)IgG antibody,abnormal glucose metabolism,abnormal lipid metabolism,and gallbladder diseases(cholecystitis,gallstone disease,gallbladder polyp,post-cholecystectomy)of all subjects were reviewed and analyzed.The collected data were sorted out and statistically analyzed by EXCEL table and SPSS 24.0.The collected data were analyzed by K-S normality test,single factor variance analysis,t test,chi-square test and binary Logistic regression analysis,and then the risk factors were summarized.Results:1.A total of 1056 patients in NAFLD group and 1123 cases in non-NAFLD group were collected between August 2015 and September 2018 in the physical examination Center of the second Hospital of Jilin University.The ratio of male to female in NAFLD group was 1.70: 1,and that in control group was 1.36: 1.The prevalence of NAFLD in male was higher than that in female,and the difference was statistically significant.BMI,LSM in NAFLD group was significantly higher than that in non-NAFLD group(P<0.05).ALT,AST,?-GGT,ALP,TG,TC,LDL-C,SUA,Scr,BUN,FPG were higher than those in control group,while HDL-C was lower than that in non-NAFLD group.The difference is statistically significant.There was no significant difference in age distribution between the two groups.2.The prevalence of obesity,overweight,abnormal lipid metabolism,abnormal glucose metabolism,biliary diseases,hyperuricemia,and Helicobacter pylori infection in NAFLD group was higher than those in non-NAFLD group,and the difference was statistically significant.3.Multivariate Logistic regression analysis results showed that male,high BMI,LSM(elevated),ALT(elevated),UA(elevated),TG(elevated),LDL-C(elevated),HDL-C(decreased),FPG(elevated),and Hp infection were independent risk factors for NAFLD.The OR values were 2.413,1.843,1.051,1.031,1.003,1.279,1.538,0.645,1.201,1.472,respectively.4.According to CAP value,the patients in NAFLD group were divided into mild,moderate and severe fatty liver groups,including 523 cases(49.5%)in mild fatty liver group,298 cases(28.2%)in moderate fatty liver group and 235 cases(22.3%)in severe fatty liver group.The mean value of BMI,LSM,ALT,UA increased with the aggravation of hepatic steatosis.The multiple comparisons ofLSM,ALT,SUA and BMI among the three groups showed that there were significant differences in BMI among the three groups(P<0.05).There was significant difference in LSM between mild fatty liver group and severe fatty liver group(P<0.05),but there was no significant difference between mild fatty liver group and moderate fatty liver group,moderate fatty liver group and severe fatty liver group(P>0.05).There was significant difference in ALT between mild fatty liver group and severe fatty liver group(P<0.05),but there was no significant difference between mild fatty liver group and moderate fatty liver group,moderate fatty liver group and severe fatty liver group(P>0.05).There was significant difference in UA between mild fatty liver group and severe fatty liver group and between moderate fatty liver group and severe fatty liver group,but there was no significant difference between mild fatty liver group and moderate fatty liver group(P>0.05).5.The proportion of male in mild fatty liver group,moderate fatty liver group and severe fatty liver group was 63.1%,62.1%,64.3%,and there was no statistically significant difference between three groups(P>0.05).The infection rate of Helicobacter pylori in three groups was 36.9%,40.9% and 47.2%,respectively.The HP infection rate increased with the severity of hepatic steatosis,and the difference was statistically significant(P< 0.05).Conclusion:1.The patients with NAFLD can be screened early by measuring BMI,biochemical index,CAP value and LSM.2.The patients with obesity,overweight,gallbladder diseases(cholecystitis,gallstone disease,gallbladder polyp,post-cholecystectomy),abnormal glucose metabolism,abnormal lipid metabolism,hyperuricemia,and Hp infection patients should routinely screen NAFLD.3.Male,high BMI,LSM(elevated),ALT(elevated),UA(elevated),TG(elevated),LDL-C(elevated),HDL-C(decreased),FPG(elevated),and Hp infection were independent risk factors for NAFLD,and NAFLD patients should pay attention to controling and monitoring above indicators.4.The prevalence of NAFLD in men in Changchun was significantly higher than that in women.Clinicians should strengthen the NAFLD survey and education in male population.