中老年少肌癥與非酒精性脂肪肝的關聯研究

許雪娟　陳景嫻　欒曉軍　陳勁松

【摘要】 目的：探討中老年原發性少肌癥與非酒精性脂肪肝（non-alcoholic fatty liver，NAFLD）的獨立關聯。方法：回顧性分析2015年1月-2017年12月本院體檢者161例的臨床資料，均進行相關人體測量學指標測定、血生化代謝指標檢測、全身各部位脂肪量及肌肉量檢測、肝臟脂肪病變（CAP）及肝硬化程度（LSM）檢測。根據骨骼肌指數（SI）分為少肌癥組和正常組，統計分析兩組患者的一般資料、脂肪病變的不同程度和比例，同時進行SI和CAP的曲線擬合分析；用多元回歸分析少肌癥與NAFLD在調整了年齡、BMI、血糖、血脂等多個因素之后的關聯。結果：本研究少肌癥發病率為13.66%（22/161）；少肌癥組CAP高于正常組（P<0.05）；少肌癥組肝臟脂肪病變較正常組嚴重，中度和重度脂肪肝比例較正常組增多（P<0.05）；曲線擬合分析顯示SI與CAP存在線性負相關；調整年齡、BMI、血糖、血脂、肝功能、炎癥、軀干四肢脂肪比等因素后[β=-95.53，95%CI（-223.79，-82.73），P=0.014]。結論：中老年原發性少肌癥與NAFLD具有獨立線性負相關。

【關鍵詞】 非酒精性脂肪肝； 少肌癥； 骨骼肌； 糖化血紅蛋白； 血脂； 少肌性肥胖

Association between Sarcopenia and Non-alcoholic Fatty Liver Disease in the Middle-aged and Elderly People/XU Xuejuan，CHEN Jingxian，LUAN Xiaojun，et al.//Medical Innovation of China，2018，15（13）：001-006

【Abstract】 Objective：To investigate the association between primary sarcopenia and non-alcoholic fatty liver（NAFLD） in the middle-aged and elderly people.Method：The clinical data of 161 cases of physical examination from January 2015 to December 2017 in our hospital were analyzed.The measurements of anthropometry，blood biochemical metabolism，fat and muscle mass in all parts of the body，liver fat disease（CAP） and liver cirrhosis（LSM） were measured.According to the skeletal muscle index（SI），they were divided into sarcopenia group and normal group.The general data of two groups，the different degree and proportion of the fat lesions were analyzed，and the curve fitting analysis of SI and CAP was carried out at the same time，and multiple regression analysis was used to analyze the association between sarcopenia and NAFLD after adjusting for multiple models such as age，BMI，blood sugar，blood lipids and other models.Result：The incidence of sarcopenia in this study was 13.66%（22/161）.The CAP in sarcopenia group was higher than that of normal group（P<0.05）.The fatty lesions of liver in sarcopenia group were more serious than those of normal group，and the proportion of moderate and severe fatty liver was higher than those of normal group（P<0.05）.Curve fitting analysis showed that there was a linear negative correlation between SI and CAP.After adjusting for age，BMI，blood sugar，blood lipid，liver function，inflammation，body fat ratio of the trunk[β=-95.53，95%CI（-223.79，-82.73），P=0.014].Conclusion：Primary sarcopenia in the middle-aged and elderly people has independent negative correlation with CAP.

【Key words】 Non-alcoholic fatty liver； Sarcopenia； Skeletal muscle； HbA1c； Lipid； Sarcopenic obesity

First-authors address：The First Peoples Hospital of Foshan，Foshan 528000，China