| Part 1 Prevalence of nonalcoholic fatty liver disease in Ningyang county,Shandong provinceBackground:Changes to a more sedentary lifestyle and a more high-calorie low-fiber diet have led to a worldwide increase in obesity and an increasing incidence of nonalcoholic fatty liver disease.The prevalence of nonalcoholic fatty liver disease varies greatly in different regions,races,ages and genders.According to a meta-analysis,the global prevalence of non-alcoholic fatty liver disease diagnosed by imaging is about 25.24%,with the highest prevalence in the Middle East and North America(over 30%)and the lowest in Africa(13.48%).It is reported that the prevalence rate of non-alcoholic fatty liver disease in China is 15-30%,and the prevalence is increasing gradually and the age is getting younger.China has a vast territory,and people in different regions,especially rural residents,have different lifestyles.The prevalence rate of non-alcoholic fatty liver disease is quite different.The main purpose of this study is to analyze the incidence of non-alcoholic fatty liver diagnosed by ultrasound in Ningyang county,Shandong province,and the prevalence rate under the stratification of gender,age and risk factors,so as to provide a basis for the prevention and treatment of the disease.Methods:The epidemiological data of metabolic diseases in Ningyang county,Shandong province from July to December 2014 were retrospectively analyzed.A total of 6849 subjects were selected.General information recorded through questionnaires,including age,sex,past medical history and drug use,etc.;Physical examination data include height,weight,waist circumference,blood pressure,etc.Laboratory examination data include liver and kidney function,blood lipid profile,blood glucose,etc.Ultrasound examination data included liver and neck vascular ultrasound results.The prevalence rate of non-alcoholic fatty liver disease diagnosed by ultrasound was statistically analyzed,and the prevalence of each gender,age and risk factor was compared.Results:1.Overall prevalence of nonalcoholic fatty liver disease and prevalence of nonalcoholic fatty liver disease in different age groups:a total of 2,347 patients with nonalcoholic fatty liver disease were detected in the study population,with the prevalence rate of 34.3%.Among the study population,the prevalence rates of 18-29 years old group,30-39 years old group,40-49 years old group,50-59 years old group,60-69 years old group and over 70 years old group were 21.7%,29.5%,36.5%,41.9%,32.4%and 27.3%,respectively.2.Age and gender prevalence of nonalcoholic fatty liver disease:the prevalence was 33.7%in male population and 34.5%in female population.The prevalence rates of male patients aged 1 8-29,30-39,40-49,50-59,60-69 and over 70 years were 33.3%,50.5%,42.9%,37.4%,23.5%and 18.8%,respectively.The prevalence rates of 18-29-,30-39-,40-49-,50-59-,60-69-and 70-year-old women were 16.0%,22.7%,34.5%,43.2%,36.2%and 33.1%,respectively.3.Prevalence survey results of nonalcoholic fatty liver disease in high-risk groups such as diabetes,hypertension,obesity or overweight,dyslipidemia:the prevalence of nonalcoholic fatty liver disease in hypertension patients was 42.7%.The prevalence was 36.6%in male hypertension patients and 45.3%in female,both higher than the normal blood pressure group.The prevalence of nonalcoholic fatty liver disease was 35.4%in overweight patients,34.4%in overweight men and 35.8%in overweight women,both higher than the normal weight group.The prevalence of nonalcoholic fatty liver disease in obese patients was 70.3%,including 69.7%in obese men and 70.5%in obese women,both higher than the normal weight group.The prevalence of nonalcoholic fatty liver disease in diabetic patients was 49.7%,including 44.0%in male diabetic patients and 52.0%in female diabetic patients,both higher than that in the normal weight group.The prevalence of nonalcoholic fatty liver disease in patients with impaired fasting glucose or impaired glucose tolerance was 34.7%,including 34.8%in male patients and 34.7%in female patients,both higher than the normal group.The prevalence of nonalcoholic fatty liver disease was 51.2%and 66.6%,respectively,in the population with marginal and high-risk elevated serum triglyceride concentrations,both significantly higher than the prevalence in the population with normal serum triglyceride concentrations(27.2%).In the population with marginal and high-risk increase of serum low-density lipoprotein cholesterol concentration,the incidence of nonalcoholic fatty liver disease was 39.8%and 44.2%respectively,both significantly higher than the prevalence in the population with normal serum low-density lipoprotein cholesterol concentration(3 1.2%).The prevalence of nonalcoholic fatty liver disease was 32.4%and 48.8%,respectively,in the group with marginal and high-risk reduction of serum high-density lipoprotein cholesterol concentration,both significantly higher than the incidence in the group with normal serum high-density lipoprotein cholesterol concentration(19.5%).4.The prevalence of nonalcoholic fatty liver disease in each population grouped by the cumulative score of components of the metabolic syndrome showed that the higher the cumulative score of components of the metabolic syndrome was,the higher the prevalence of nonalcoholic fatty liver disease was,both in males and females.Conclusions:In this study,the prevalence of nonalcoholic fatty liver disease was 34.3%.Among the male population,the prevalence was highest between 30 and 49 years old,and decreased after 60 years old.However,the prevalence of nonalcoholic fatty liver disease in female population gradually increases with age before 60 years old,with the highest prevalence in the age group of 50-59 years old and a declining trend after 60 years old.Before the age of 50,the prevalence of nonalcoholic fatty liver disease in men is higher than that in women,and after the age of 50,the prevalence in women is higher than that in men.The prevalence of nonalcoholic fatty liver disease decreased over the age of 60 years both in men and women.The prevalence of nonalcoholic fatty liver disease was significantly increased in high-risk groups such as diabetes,hypertension,obesity or overweight,and dyslipidemia,and the higher the cumulative score of each component of the metabolic syndrome was,the higher the incidence of nonalcoholic fatty liver disease was,both in males and females.Part 2 Analysis of risk factors of nonalcoholic fatty liver disease and its relationship with arteriosclerosisBackground:nonalcoholic fatty liver disease is a genetic susceptibility and insulin resistance related to metabolic changes,liver steatosis and stress damage as the main symptoms of chronic liver diseases,from the pure liver lipid deposition,the adipose sex hepatitis,liver fibrosis and cirrhosis of the liver of a broad range of disease.In the coming decades,with the increasing number of people with nonalcoholic fatty liver disease,it will replace viral hepatitis as the most important cause of end-stage liver disease and liver transplantation.Nonalcoholic fatty liver disease is not only associated with mortality and morbidity from liver disease itself,but also with an increased risk of cardiovascular disease.At present,nonalcoholic fatty liver disease has become a global public health problem,which requires the attention of the public to further evaluate its risk factors and formulate prevention and intervention measures.Nonalcoholic fatty liver disease is often closely related to obesity,diabetes,abnormal lipid metabolism,insulin resistance and other cardiovascular disease risk factors,and is considered as the manifestation of metabolic syndrome in the liver.NAFLD is closely related to the risk factors for CVD,but it is unclear whether NAFLD is independently related to atherosclerosis.How NAFLD is linked to atherosclerosis is still disputed.It is very interesting to know whether NAFLD can act as a causal risk factor for atherosclerosis or an intermediate phenotype in the metabolic syndrome pathway,or whether it is just an isolated disease sharing common metabolic characters with atherosclerosis.The purpose of this study was to understand the prevalence of nonalcoholic fatty liver disease in adults in rural areas of northern China,and to conduct statistical analysis on the risk factors of nonalcoholic fatty liver disease and its relationship with atherosclerosis.Methods:this study was a cross-sectional study with community as the unit.The study population was from the epidemiological survey data of metabolic diseases in Ningyang county,Shandong province from July 2014 to December 2014.A total of 6849 subjects were included.General information,including age,sex,past medical history and drug use,was recorded through questionnaires.Height,weight,waist circumference,blood pressure and other data were obtained through physical examination.All subjects underwent ultrasound examination of liver and carotid artery,as well as laboratory examination of liver and kidney function,blood lipid profile and blood glucose.Non-alcoholic fatty liver disease was divided into groups according to whether there was non-alcoholic fatty liver disease,and the clinical characteristics of the subjects in each age and gender stratification group were compared and analyzed.The risk factors of non-alcoholic fatty liver disease and its correlation with arteriosclerosis were statistically analyzed by Logistic regression analysis.SPSS 23.0 software was used for statistical analysis of the collected data.Results:1.The crowd of nonalcoholic fatty liver disease are more prone to have higher body mass index,blood pressure,increased liver enzymes,higher fasting glucose,glycosylated hemoglobin,and uric acid levels and blood lipid spectrum with increased triglycerides,low density lipoprotein cholesterol increased,reduced high-density lipoprotein cholesterol.The crowd of nonalcoholic fatty liver is more prone to diabetes,dyslipidemia,hypertension,obesity,etc.2.Risk factor analysis shows that:high blood pressure,increased body mass index,waist circumference increased,increased triglyceride,low-density lipoprotein cholesterol increased,alanine aminotransferase increased,glutamine transpeptidase increased,increased uric acid and diabetes are independent risk factors for the development of alcoholic fatty liver,high-density lipoprotein cholesterol increases are protective factors of alcoholic fatty liver disease,age stratification in 60-69 age group,more than 70-year-old group are protective factors of alcoholic fatty liver disease.Nonalcoholic fatty liver disease shares common risk factors with atherosclerosis,such as hypertension,diabetes,and high serum low-density lipoprotein cholesterol levels.However,obesity has a more significant effect on nonalcoholic fatty liver disease,and its dyslipidemia is characterized by increased triglycerides,increased low-density lipoprotein cholesterol,and decreased high-density lipoprotein cholesterol cholesterol.Smoking and aging were significant risk factors for atherosclerosis in male.4.Logistic regression analysis of the organizational details showed that there was no independent correlation between non-alcoholic fatty liver disease and arteriosclerosis after adjusting for various confounders.When nonalcoholic fatty liver disease is combined with arteriosclerosis,people have higher levels of blood lipid,blood sugar,blood pressure and body mass index,and the incidence of hypertension,diabetes,dyslipidemia and metabolic syndrome is increased.Conclusions:NAFLD and atherosclerosis have common metabolic characteristics,such as hypertension,diabetes,and higher serum LDL-c level.Patients with NAFLD in combination with atherosclerosis were found to have a more severe metabolic burden and greater chances of having hypertension,diabetes,dyslipidemia,and higher metabolic syndrome scores than those in the other groups. |
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