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中华实验和临床感染病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (02) : 157 -161. doi: 10.3877/cma.j.issn.1674-1358.2016.02.006

临床论著

幽门螺杆菌感染与非酒精性脂肪肝的相关性
王璐1, 房娜2, 郝彦琴1, 赵龙凤1,†()   
  1. 1. 030001　太原市，山西医科大学第一医院感染病科
    2. 030001　太原市，山西省人民医院体检中心
  • 收稿日期:2015-10-27 出版日期:2016-04-15
  • 通信作者: 赵龙凤
  • 基金资助:
    山西省国际科技合作项目(No. 2014081053-2)

The relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease

Lu Wang1, Na Fang2, Yanqin Hao1, Longfeng Zhao1,†()   

  1. 1. Department of Infectious Diseases, The First Affliated Hospital of Shanxi Medical University, Taiyuan 030001, China
    2. Physical Examination Center, The People’s Hospital of Shanxi Province, Taiyuan 030001, China
  • Received:2015-10-27 Published:2016-04-15
  • Corresponding author: Longfeng Zhao
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王璐, 房娜, 郝彦琴, 赵龙凤. 幽门螺杆菌感染与非酒精性脂肪肝的相关性[J]. 中华实验和临床感染病杂志(电子版), 2016, 10(02): 157-161.

Lu Wang, Na Fang, Yanqin Hao, Longfeng Zhao. The relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(02): 157-161.

目的

探讨幽门螺杆菌（Hp）现症感染与非酒精性脂肪肝（NAFLD）的相关性。

方法

采用横断面调查研究方法，分析2014年4月至2014年7月于山西省人民医院体检中心进行健康体检者中体检数据完整、行13C-尿素呼气试验检测Hp及腹部超声检查的受试者3 447例。依据腹部超声检查结果分为非脂肪肝组2 093例，NAFLD组1 354例。应用非条件Logistic回归分析NAFLD患病率与Hp感染及代谢综合征相关组分间的关系。

结果

体质量指数（BMI）、甘油三酯（TG）和血尿酸（UA）水平在男性及女性体检者中均为NAFLD患病的危险因素，男性体检者中舒张压、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）为NAFLD危险因素；女性体检者中，高密度脂蛋白胆固醇（HDL-C）为NAFLD保护因素。NAFLD患病率与总胆固醇（TC）水平及Hp感染关联无显著性。

结论

NAFLD患病率可能与BMI、TG、UA、LDL-C、FPG和HDL-C水平存在相关性，而与TC水平及Hp感染的相关性不显著。

关键词: 幽门螺杆菌, 脂肪肝, 非酒精性, 血脂, 血糖, 血尿酸
Objective

To investigate the relationship between Helicobacter pylori (Hp) infection and nonalcoholic fatty liver disease (NAFLD).

Methods

The data from 3 447 cases who received 13C urea breath test to detect Hp and abdominal ultrasound examination from April to July 2014 in the physical examination center of the People’s Hospital of Shanxi Province were analyzed by cross-sectional analysis methods. The subjects were divided into NAFLD group and non-NAFLD group on the basis of abdominal ultrasound examination results, with 1 354 and 2 093 cases, respectively. The relationship between NAFLD prevalence rate and Hp infection status and the components of metabolic syndrome were analyzed by Unconditioned Logistic regression.

Results

In both cases, body mass index (BMI), triglycerides (TG) and uric acid (UA) levels were positive correlated with the prevalence rates of NAFLD. In the male subjects, low-density lipoprotein cholesterol (LDL-C), diastolic nlood pressure (DBP) and fasting plasma glucose (FPG) levels were positive correlated with NAFLD. In the female subjects, high-density lipoprotein cholesterol (HDL-C) level was negative correlated with NAFLD. There was no significant difference in the infection of Hp and level of total cholesterol (TC) in both gender.

Conclusions

There may be a connection between NAFLD prevalence rate and BMI, levels of TG, UA, LDL-C, HDL-C, FPG and DBP, but for infection rate of Hp and level of TC, there was no significant correlation.

Key words: Helicobacter pylori, Nonalcoholic fatty liver disease, Blood lipids, Fasting plasma glucose, Uric acid
表1 非脂肪肝组与NAFLD组的数据特征
指标 非脂肪肝组（n = 2 093） NAFLD组（n = 1 354） 统计量 P值
年龄（岁） 44（34，53） 47（39，54） U =-5.495 0.000
性别（男/女） 927/1 166 1 018/336 χ2 = 319.148 0.000
收缩压（mmHg） 118（108，129） 127（117，140） U =-16.037 0.000
舒张压（mmHg） 74（68，80） 81（76，90） U =-19.582 0.000
BMI（kg/m2） 23.20（21.34，25.08） 26.90（25.20，28.74） U =-33.823 0.000
TG（mmol/L） 1.10（0.81，,1.53） 1.96（1.37，2.68） U =-28.505 0.000
TC（mmol/L） 4.48（3.94，5.09） 4.78（4.21，5.40） U =-8.778 0.000
HDL-C（mmol/L） 1.38（1.18，1.62） 1.13（0.97，1.34） U =-21.008 0.000
LDL-C（mmol/L） 2.40（2.03，3.02） 2.80（2.10，3.32） U =-9.478 0.000
FPG（mmol/L） 5.15（4.78，5.57） 5.51（5.04，6.11） U =-14.489 0.000
UA（μmol/L） 276.38（233，334） 349.50（295.15，411.99） U =-22.226 0.000
Hp（阳性/阴性） 992/1 101 713/641 χ2 = 9.109 0.003
表2 男性组NAFLD患病与Hp感染及代谢综合征组分的相关性
指标 Exp（B） 95%CI P值
BMI 0.670 0.636～0.706 0.000
舒张压 0.976 0.961～0.990 0.001
TG 0.591 0.508～0.688 0.000
LDL-C 0.679 0.504～0.916 0.011
UA 0.996 0.995～0.998 0.000
FPG 0.835 0.768～0.908 0.000
表3 女性NAFLD患病与Hp感染及代谢综合征组分的相关性
指标 Exp（B） 95%CI P值
BMI 0.688 0.645～0.734 0.000
TG 0.691 0.544～0.878 0.002
LDL-C 3.822 1.927～7.581 0.000
血尿酸UA 0.994 0.992～0.997 0.000
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