中老年少肌症与非酒精性脂肪肝的关联研究

许雪娟　陈景娴　栾晓军　陈劲松

【摘要】 目的：探讨中老年原发性少肌症与非酒精性脂肪肝（non-alcoholic fatty liver，NAFLD）的独立关联。方法：回顾性分析2015年1月-2017年12月本院体检者161例的临床资料，均进行相关人体测量学指标测定、血生化代谢指标检测、全身各部位脂肪量及肌肉量检测、肝脏脂肪病变（CAP）及肝硬化程度（LSM）检测。根据骨骼肌指数（SI）分为少肌症组和正常组，统计分析两组患者的一般资料、脂肪病变的不同程度和比例，同时进行SI和CAP的曲线拟合分析；用多元回归分析少肌症与NAFLD在调整了年龄、BMI、血糖、血脂等多个因素之后的关联。结果：本研究少肌症发病率为13.66%（22/161）；少肌症组CAP高于正常组（P<0.05）；少肌症组肝脏脂肪病变较正常组严重，中度和重度脂肪肝比例较正常组增多（P<0.05）；曲线拟合分析显示SI与CAP存在线性负相關；调整年龄、BMI、血糖、血脂、肝功能、炎症、躯干四肢脂肪比等因素后[β=-95.53，95%CI（-223.79，-82.73），P=0.014]。结论：中老年原发性少肌症与NAFLD具有独立线性负相关。

【关键词】 非酒精性脂肪肝； 少肌症； 骨骼肌； 糖化血红蛋白； 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