Prevalence of and risk factors for hepatic steatosis in northern Italy
Prevalence of and risk factors for hepatic steatosis in northern Italy
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DOI：
10.7326/0003-4819-132-2-200001180-00004
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发表时间：
2000-01-18
影响因子：
39.2
通讯作者：
Tiribelli, C
中科院分区：
文献类型：
--
作者：
Bellentani, S;Saccoccio, G;Tiribelli, C
背景资料：虽然肝脂肪变性在临床实践中越来越常见，但其患病率和危险因素尚不清楚。目的：调查肝脂肪变性的患病率和危险因素，如饮酒和肥胖。设计：横断面观察性研究。设置：Dionysos研究的参与者。患者：257名参与者被分配到四个类别之一（67名对照者、66名肥胖者、69名重度饮酒者和55名肥胖重度饮酒者）。乙醇摄入量，通过经验证的调查问卷评估，表示为每日（g/d）和终生（kg）摄入量，以及体重，表示为体重指数。结果：与对照组（16.4%）相比，重度饮酒者（46.4%）和肥胖者（75.8%）脂肪变性的患病率明显增高（95%CI为34%~ 59%），肥胖者（63%~ 85%）脂肪变性的患病率明显增高（95%CI为8%~ 25%）。在94.5%（CI，85%至99%）的肥胖重度饮酒者中发现脂肪变性。与对照组相比，重度饮酒者脂肪变性的风险高2.8倍（CI，1.4- 7.1倍），肥胖者高4.6倍（CI，2.5- 11.0倍），肥胖和重度饮酒者高5.8倍（CI，3.2- 12.3倍）。在重度饮酒者中，肥胖使脂肪变性的风险增加2倍（CI，1.5倍至3.0倍）（P < 0.001），但在肥胖者中，重度饮酒仅使风险增加1.3倍（CI，1.02倍至1.6倍）（P = 0.0053）。丙氨酸氨基转移酶和甘油三酯水平升高是脂肪变性的最可靠的标志物。结论：脂肪变性是经常遇到的健康人，几乎总是存在于肥胖的人谁每天喝超过60克的酒精。脂肪变性与肥胖的相关性比与酗酒的相关性更强，这表明超重比饮酒在肝脏脂肪积累中的作用更大。
Background: Although hepatic steatosis is seen with increasing frequency in clinical practice, its prevalence and risk factors are unknown.Objective: To investigate the prevalence of and risk factors for hepatic steatosis, such as alcohol consumption and obesity.Design: Cross-sectional, observational study.Setting: Participants in the Dionysos Study.Patients: 257 participants assigned to one of four categories (67 controls, 66 obese persons, 69 heavy drinkers, and 55 obese heavy drinkers).Measurements: Ethanol intake, assessed by a validated questionnaire and expressed as daily (g/d) and lifetime (kg) consumption, and body mass, expressed as body mass index. Biochemical tests of liver and metabolic function and hepatic ultrasonography were done.Results: The prevalence of steatosis was increased in heavy drinkers (46.4% [95% CI, 34% to 59%]) and obese persons (75.8% [CI, 63% to 85%]) compared with controls (16.4% [CI, 8% to 25%]). Steatosis was found in 94.5% (CI, 85% to 99%) of obese heavy drinkers. Compared with controls, the risk for steatosis was higher by 2.8-fold (CI, 1.4-fold to 7.1-fold) in heavy drinkers, 4.6-fold (CI, 2.5-fold to 11.0-fold) in obese persons, and 5.8-fold (CI, 3.2-fold to 12.3-fold) in persons who were obese and drank heavily. In heavy drinkers, obesity increased the risk for steatosis by twofold (CI, 1.5-fold to 3.0-fold) (P < 0.001), but heavy drinking was associated with only a 1.3-fold (CI, 1.02-fold to 1.6-fold) increase in risk in obese persons (P = 0.0053). Elevated alanine aminotransferase and triglyceride levels are the most reliable markers of steatosis.Conclusions: Steatosis is frequently encountered in healthy persons and is almost always present in obese persons who drink more than 60 g of alcohol per day. Steatosis is more strongly associated with obesity than with heavy drinking, suggesting a greater role of overweight than alcohol consumption in accumulation of fat in the liver.