Prevalence Study Of Non-alcoholic Fatty Liver Disease And Epidemiological Study On Its Relation With Glycosylated Hemoglobin

PartⅠ Prevalence survey of non-alcoholic fatty liver diseases in staff of apetrochemical corporation in Ningbo among adultsObjective:to analyze the prevalence of non-alcoholic fatty liver diseases diagnosed by B ultrasound and to provide evidences for prevention and treatment of diseases.Methods:a retrospective analysis was made on materials and B ultrasound results of 8773 employees in one large-scale petrochemical enterprise in Ningbo city.Results:2116 cases of NAFLD were detected,with the morbidity of 24.1%;the male morbidity 28.0% and the female morbidity 15.5%.The male NAFLD morbidity was higher than the female NAFLD morbidity and the difference had statistical significance(χ2=161.688,P<0.001).The morbidity of 20~ age group,30~ age group,40~ age group,50~ age group,60~ age group and over 70 age group was 7.2%,24.2%,25.6%,29.1%,30.8%,24.8%,respectively and the difference in NAFLD morbidity of different age groups had statistical significance(P<0.001).The male NAFLD morbidity did not increase evidently with aging and had a decreasing trend after 70.While female NAFLD morbidity gradually increased with aging and increased evidently after 50 years old.Among 6648 non-obese people,1000 cases of NAFLD were detected,with the morbidity of 15.0%,lower than 52.5%,that of obese people(1116/2125)and the difference had statistical significance(χ2=1131.910,P<0.001);Among non-obese people,the male NAFLD morbidity(18.5%)was evidently higher than the female NAFLD morbidity(7.3%)and the difference had statistical significance(χ2=137.679,P<0.001).The peak age range of male NAFLD was 40~69 years old while the morbidity of female NAFLD increased after 50 and then remained unchanged.Conclusion:no matter obese people or non-obese people,NAFLD morbidity increases with aging and it has a decreasing trend after 70;the male are more likely to suffer from NAFLD than the female;NAFLD morbidity among obese people is evidently higher than non-obese people.Part Ⅱ(A)Study of the relation between non-alcoholic fatty liver disease andglycosylated hemoglobin among middle-aged and aged people:aCross-Sectional StudyObjective:discuss the relation between non-alcoholic fatty liver disease(NAFLD)and glycosylated hemoglobin(Hb Alc)among middle-aged and aged people.Methods:investigate 4127 in-service workers and retirees aged 45 years old or above,and they are all from one petrochemical enterprise in Ningbo.Test their waistline,body mass index,blood pressure,fasting blood-glucose,blood lipid profile,glutamyltranspeptidase,Hb A1 c and the testing results of epigastrium B ultrasound.According to Hb A1 c level quartile,it can be divided into four groups,namely,Q1 group for 5.19%,Q2 group is >5.19%~5.4%,Q3>5.4%~5.6% and Q4 group>5.6% group.NAFLD prevalence and clinical characteristics of each group were analyzed,and logistic regression was analyzed to predict independent risk factors of NAFLD.Results:the morbidity of NAFLD is 26.6%,among which,the male 31.9%,the female 21%.The morbidity of the male is higher than that of the female,and this has statistical significance.Q1,Q2,Q3 and Q4 group,the prevalence of NAFLD were 18.5%,22.8%,25.6% and 38.1% respectively.With the increase of Hb Alc level,the morbidity of NAFLD increases.The age,systolic pressure,total cholesterol,low density lipoprotein cholesterin and fasting blood-glucose of 1123 NAFLD patients increase with the increase of Hb Alc level.Multi-factor non-conditional Logistic regression analysis indicates that Hb Alc level is related to NAFLD attack risk factor(OR=1.67,95%CI:1.15~2.43,P=0.007).Conclusion:Hb A1 c is the independent related risk factor of NAFLD and both of these are closely related to blood lipid metabolism disorder.Part Ⅱ(B)Study of the relation between non-alcoholic fatty liver disease and glycosylated hemoglobin among middle-aged and aged people:a prospectivecase-control studyObjective:to discuss the influence of Hb A1 c on the occurrence of non-alcoholic fatty liver diseases among the cohort population.Method:an epidemiological investigation on the relation between Hb A1 c and NAFLD that was developed on March 2012 was taken as the basis of the cohort study.Materials of baseline survey objects were obtained and three times of follow-up visit were conducted on March 2013,March 2014 and March 2015.After excluding NAFLD patients in the baseline period and patients lost to follow-up due to removal,death,etc.,2811 survey objects were included in this study and underwent questionnaire survey,anthropometric measuring and laboratory detection.The comparison of continuous variable adopted t test(normal distribution)or Mann-Whitney test(not according with normal distribution);the testing of categorical data rate adopted chi-square test.Cox proportional hazard model was used to analyze the relation of Hb A1 and other factors with NAFLD onset risk.Results:2811 subjects aged 58.2±9.8 years old,1664 male and 1147 female.The age,waist circumference,body mass index,systolic blood pressure,systolic pressure,glutamyltranspeptidase,fasting blood-glucose of the Hb A1 c abnormal group were all higher than that of the normal group and NAFLD morbidity of Hb A1 c abnormal group(25.4%)was higher than that of the normal group(14.9%);diastolic pressure,high density lipoprotein cholesterol were lower than that of the normal group,and the differences all had statistical significance;during intervals of three follow-up visits,there were 440 new NAFLD cases,285 male cases and 155 female cases,with the accumulated morbidity of 15.7%(440/2811).Multivariate Cox regression model analysis results indicated that the rise of Hb A1 c is related to a higher risk of NAFLD(HR=1.796,95%CI: 1.335~2.418,P=0.004).The increased Hb A1 c level after correcting gender,age,metabolic syndrome related factors was still the independent influence factor of NAFLD risk(HR=1.580,95.0% CI 1.161-2.152,P=0.004).Conclusion:the rise of Hb A1 c will increase the onset risk of NAFLD.Part Ⅲ A cross-sectional study of the relation between non-alcoholic fatty liver disease and helicobacter pylori infection among middle-aged and aged peopleObjective : The relationship between non-alcoholic fatty liver disease(NAFLD)and helicobacter pylori infection(H.pylori)was explored among middle-aged and aged people.Methods : A cross-sectional study was surveyed 5159 middle-aged and aged employees aged 45 and over in a petrochemical Enterprise of Zhenhai Refining& Chemical Company Ltd,Ningbo city.All subjects met the analytical conditions.Test their waistline,body mass index,blood pressure,fasting blood-glucose,blood lipid profile,liver function indicators,Hb A1 c,the testing results of epigastrium B ultrasound,and the testing results of H.pylori infection,and logistic regression was analyzed to predict independent risk factors of NAFLD.Results:The detection rate of NAFLD was 27.7%,32.5% were male and 19.9% were female.H.pylori infection rate of NAFLD group was higher than that of the control group and it was statistically significant(53.6% vs.49.4%,χ2=7.527,P=0.006).The multiariable logistic analysis was adopted in risk factor analysis result showed that uric acid,hypertriglyceridemia,body mass index,waistline,glycosylated hemoglobin were independent risk factors for NAFLD.H.pylori infection(OR=1.09,95%CI:0.94~1.27,P=0.257)were not independent risk factors for NAFLD.Conclusions : The gender,uric acid,aspertate aminotransferase,alanine aminotransferase,hypertriglyceridemia,body mass index,waistline,growth hormone,and glycosylated hemoglobin had relatively close relationship with NAFLD.H.pylori infection is not an independent risk factor for NAFLD among middle-aged and aged people.