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目的:分析血脂正常者发生脂肪肝的危险因素及其临床特征。方法:回顾性分析137例血脂正常的脂肪肝(血脂正常脂肪肝组)和137例血脂正常的非脂肪肝(对照组)病人的临床资料,对肥胖等相关因素进行Logistic回归分析,并比较血脂正常脂肪肝组和高脂血症脂肪肝组病人的临床特征、肝功能改变差异。结果:血脂正常患者发生脂肪肝的独立相关危险因素为嗜酒、肥胖、2型糖尿病、空腹血糖升高、高尿酸血症,其比数比(oddsrate,OR)分别为27.49、26.95、3.14、1.60和1.00。血脂正常脂肪肝组患者的γ-谷氨酰转移酶(27.7%)和球蛋白(5.8%)升高及A/G异常(13.1%)的比例均显著低于高脂血症脂肪肝组,后者相应为38.8%、12.3%和23.9%,均为P<0.05。结论:嗜酒、肥胖、2型糖尿病、空腹血糖升高和高尿酸血症是血脂正常者发生脂肪肝的独立相关危险因素。血脂正常脂肪肝组患者的肝功能损害较高脂血症脂肪肝组患者为轻。
Objective: To analyze the risk factors and clinical features of fatty liver in patients with normal blood lipids. Methods: The clinical data of 137 patients with normotensive fatty liver (dyslipidemia group) and 137 normotensive non-fatty liver patients (control group) were retrospectively analyzed. Logistic regression analysis was performed on the related factors such as obesity. The levels of serum lipids The clinical characteristics and the changes of liver function in patients with normal fatty liver and hyperlipidemia fatty liver were different. Results: Independent risk factors for fatty liver in patients with normal blood lipids were alcohol consumption, obesity, type 2 diabetes, fasting blood glucose and hyperuricemia. The odds ratios (ORs) were 27.49, 26.95 and 3.14 respectively, 1.60 and 1.00. The percentage of γ-glutamyl transferase (27.7%) and globulin (5.8%) and abnormal A / G ratio (13.1%) were significantly lower in patients with lipids-induced fatty liver than those with hyperlipidemia, The latter were 38.8%, 12.3% and 23.9%, all P <0.05. Conclusion: Alcoholism, obesity, type 2 diabetes mellitus, fasting blood glucose and hyperuricemia are independent risk factors for fatty liver in patients with normal blood lipids. Liver dysfunction in patients with lipidemia is more severe than in patients with hyperlipemia and fatty liver disease.