北京某机关人员脂肪肝与心血管病危险因素的调查 Investigation of Fatty Liver and Cardiovascular Risk Factors on Civil Servants’ of a Town in Beijing Daxing District

目的：了解和评价公务员特殊群体的脂肪肝发生状况以及与心血管病危险因素的关系，以确定预防策略、有的放矢的进行健康教育。方法：2016年9~10月对北京某镇机关单位全体277名工作人员，最小年龄23岁，最大63岁，平均年龄38.44 ± 11.52岁，其中男性165人，女性112人，通过问卷调查获得高血压、糖尿病、血脂异常等病史，通过超声获得脂肪肝情况，通过体格检查和实验室检查获得体重指数(BMI)、血压、血糖、血脂、血尿酸、肝功等数据。结果：277人中超重肥胖占63%、血脂异常占45.49%、高血压占39.7%、脂肪肝占37.1%，高尿酸血症占20.5%、肝功能异常占15.1%、糖尿病占11.1%。根据超声结果将受检人分为脂肪肝组和对照组进一步分析发现：脂肪肝组的平均年龄、血压水平包括收缩压和舒张压、血糖、总胆固醇(TC)，甘油三酯(TG)，低密度脂蛋白胆固醇(LDL-C)，血尿酸(UA)，肌酐(Cr)，谷丙转氨酶(ALT)和谷草转氨酶(AST)水平均明显高于对照组，而高密度脂蛋白胆固醇(HDL-C)水平明显低于对照组，P值在0.01~<0.0001之间。脂肪肝组的男性、肥胖超重、高血压、糖尿病、高TG、低HDL-C、高LDL-C、高UA、高ALT、高AST者明显高于对照组，是对照组的2.1~32倍。结论：北京大兴区某镇机关公务员的脂肪肝和心血管病危险因素明显高于我国的平均水平，脂肪肝与超重肥胖、血压、血脂、血糖、尿酸等密切相关。长期伏案工作、缺乏体育运动、超重肥胖可能是导致脂肪肝和其他代谢性疾病等的主要原因。 Aim: To understand and evaluate nonalcoholic fatty liver disease (NAFLD) and the cardiovascular risk factors on a special group of civil servants, in order to determine the prevention strategy, target for their health education. Methods: from September to October in 2016, all civil servants (277) of a town in Beijing Daxing District, aging from 23 to 63 years old (38.44 ± 11.52) including 165 male and 112 female were investigated. The history of hypertension, type 2 diabetes (2DM), dyslipidemia, etc. was obtained through the questionnaire, NAFLD was diagnosed by the ultrasound, and the data of body mass index (BMI), blood pressure, glucose, lipids, uric acid, liver function and renal function were obtained through physical examination and laboratory tests. Result: among the 277 people, overweight obesity was 63%, dyslipidemia 63%, hypertension 39.7%, NAFLD 37.1%, high uric acid 20.5%, abnormal liver function 15.1%, 2DM 11.1%. Based on ultrasound, persons were divided into NAFLD group and the control group. The average age, levels of systolic and diastolic blood pressure, fast blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), uric acid (UA), creatinine (Cr), BMI, alanine aminotransferase (ALT) and aspertate aminotransferase (AST) were significantly higher, and the level of high-density lipoprotein cholesterol (HDL-C) significantly lower in NAFLD group than those of control group, P value in 0.01 - <0.0001. The rates of hypertension, 2DM, high TG and low LDL-C, high UA, overweigh/obesity, high ALT, AST were significantly higher (OR 2.1 - 32) in NAFLD group than in the control group. Conclusions: NAFLD and cardiovascular disease risk factors on the civil servants of a town in Beijing Daxing District are significantly higher. NAFLD is closely related with the overweight obesity, blood pressure, blood lipid, blood sugar, uric acid and so on. Working at his desk for a long time, lack of physical exercise, overweight\obesity could be the leading cause for NAFLD and other metabolic diseases.