1.上海市嘉定区中医医院,上海市嘉定区博乐路222号,201899
2.上海市嘉定区安亭镇社区卫生服务中心
3.上海中医药大学附属龙华医院
jiliver@vip.sina.com
收稿:2021-11-15,
修回:2022-03-02,
纸质出版:2022-08-17
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肖定洪,梁春耕,徐辉等.上海市老年人群代谢相关脂肪性肝病与体质相关性的横断面调查[J].中医杂志,2022,63(16):1559-1565.
XIAO Dinghong,LIANG Chungeng,XU Hui,et al.Correlation between Metabolic Associated Fatty Liver Disease and Constitutional Types of Chinese Medicine in Elderly in Shanghai: A Cross-sectional Study[J].Journal of Traditional Chinese Medicine,2022,63(16):1559-1565.
肖定洪,梁春耕,徐辉等.上海市老年人群代谢相关脂肪性肝病与体质相关性的横断面调查[J].中医杂志,2022,63(16):1559-1565. DOI: 10.13288/j.11-2166/r.2022.16.011.
XIAO Dinghong,LIANG Chungeng,XU Hui,et al.Correlation between Metabolic Associated Fatty Liver Disease and Constitutional Types of Chinese Medicine in Elderly in Shanghai: A Cross-sectional Study[J].Journal of Traditional Chinese Medicine,2022,63(16):1559-1565. DOI: 10.13288/j.11-2166/r.2022.16.011.
目的
2
探究上海市老年人群代谢相关脂肪性肝病(MAFLD)与中医体质的相关性。
方法
2
采用回顾性横断面调查方法,选取嘉定区2020年度60岁以上老年人群健康体检数据,共纳入66 435例分析。分析MAFLD患者体质分布,采用二元Logistic回归模型虚拟变量法,以平和质为基准分析MAFLD与偏颇体质的相关性。对与MAFLD存在显著正相关的偏颇体质,选取理化检测数据完整的病例采用二元Logistic回归分析进行危险因素相关性分析。
结果
2
老年MAFLD体质类型分布为平和质(67.9%)、痰湿质(10.4%)、气虚质(9.2%)、阴虚质(6.6%)、湿热质(2.4%)、阳虚质(2.2%)、血瘀质(1.0%)、气郁质(0.2%)、特禀质(0.1%)。校正性别、年龄后,气虚质[
OR
(95%
CI
)=0.710(0.674,0.747),
P
<0.001]、阳虚质[
OR
(95%
CI
)=0.806(0.727,0.893),
P
<0.001]、阴虚质[
OR
(95%
CI
)=1.111(1.042,1.185),
P
=0.001]、痰湿质[
OR
(95%
CI
)=2.240(2.107,2.381),
P
<0.001]、气郁质[
OR
(95%
CI
)=0.662(0.494,0.887),
P
=0.006]在MAFLD组与非MAFLD组间差异有统计学意义。二元Logistic回归模型,痰湿质MAFLD与非MAFLD者比较,性别、年龄、体重指数(BMI)、血红蛋白、丙氨酸氨基转移酶(ALT)、尿酸、胆固醇、甘油三酯、低密度脂蛋白胆固醇、蛋白尿与痰湿质独立相关(
P
<0.05);年龄、腰臀比、BMI、ALT、甘油三酯、蛋白尿与阴虚质独立相关(
P
<0.05)。
结论
2
上海市老年人MAFLD与痰湿质、阴虚质呈独立正相关,为老年人MAFLD的特征性体质;痰湿质老年MAFLD患者存在显著的肥胖及尿酸代谢、血脂代谢紊乱;阴虚质老年MAFLD患者存在显著的肥胖及血脂代谢紊乱。
Objective
2
To investigate the correlation between metabolic associated fatty liver disease (MAFLD) and constitutional types of traditional Chinese medicine (TCM) in elderly in Shanghai.
Methods
2
A retrospective cross‑sectional study was performed using data of elders over 60 years old in 2022,and a total of 66
435 elders were included. The MAFLD's constitutional types of Chinese Medicine were analyzed. The correlation between MAFLD and pathologcial constitutions was analyzed using pseudo-variables of binary logistic regression model,based on gentleness type. For pathological constitutions which were positively correlated with MAFLD,cases with complete physical and chemical test data were selected,and binary logistic regression analysis was used to explore the correlation of risk factors.
Results
2
The constitutional types of MAFLD in the elders were gentleness type (67.9%),phlegm-dampness type (10.4%),qi-deficiency type (9.2%),yin-deficiency type (6.6%),dampness-heat type (2.4%),yang-deficiency type (2.2%),blood-stasis type (1.0%),qi-stagnation type (0.2%),special diathesis type (0.1%). After adjusted for gender and age,
qi
-stagnation type [
OR
(95%
CI
)= 0.710 (0.674,0.747),
P
<0.001],yang-deficiency type [
OR
(95%
CI
)= 0.806 (0.727,0.893),
P
<0.001],yin-deficiency type [
OR
(95%
CI
)= 1.111(1.042,1.185),
P
= 0.001],phlegm-dampness type [
OR
(95%
CI
)= 2.240 (2.107,2.381),
P
<0.001], qi-stagnation type [
OR
(95%
CI
)= 0.662 (0.494,0.887),
P
= 0.006] is significantly different between MAFLD and non-MAFLD groups. Binary logistic regression analysis showed that gender,age,body mass index (BMI),hemoglobin,alanine aminotransferase (ALT),uric acid,cholesterol,triglyceride,low-density lipoprotein cholesterol,proteinuria was significantly correlated with phlegm-dampness type when comparing between MAFLD and non-MAFLD (
P
<0.05),while age,waist hip ratio,BMI,ALT,triglyceride,and proteinuria was independently correlated with yin-deficiency type of MAFLD (
P
<0.05).
Conclusion
2
MAFLD in elders in Shanghai is independently and positively correlated with phlegm-dampness type and yin-deficiency type,which are the characteristic constitutional types of Chinese medicine. There were obesity,uric acid metabolism and blood lipid metabolism disorder in elderly MAFLD patients with phlegm-dampness type,while there were significant fat,disorder of uric acid metabolism and lipid metabolism in the elderly with yin-deficiency constitution type.
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