Objective To investigate the remission rate and influence factors of non-alcoholic fatty liver disease ( NAFLD) in Shanghai Baosteel employees. Methods Subjects free of abnormal aminotransferase and negative for hepatitis B virus surface antigen with alcohol consumption of less than 140 g/week were identified from employees of Shanghai Baosteel who underwent voluntary medical checkups at a 2-year interval between 1999 and 2001. Results The analyzed population consisted of 440 patients with NAFLD at baseline and 4867 subjects without fatty liver both at baseline and at the end of follow-up (group without fatty liver). Among NAFLD patients at baseline,60 subjects (13.6%) were found to have no fatty liver (group with remission of fatty liver) and the others (380 subjects) still had fatty liver (group without remission of fatty liver) at the end of follow-up. The remission rate of fatty liver in women younger than 50 years old (33. 3% ,3/9) was higher than in women 50 years old and over (4. 3% ,l/46)(χ2 =4. 969,P <0. 01). The remission rate of fatty liver in patients with NAFLD decreased gradually with increased body mass index (BMI) at baseline, dropping from 18. 2% in subjects with normal weight, 16. 5% in overweight patients, 13. 5% in obese patients to 7.8% in patients with severe obesity.There was a significant difference in the changes of BMI between 2001 and 1999 among group with remission of fatty liver( - 0. 26 ±1.18), group without remission of fatty liver ( 0. 39 ±1.13) and group without fatty liver (0. 50 ±1. 29) (F = 11.41,P<0. 01). This was also was true of the changes of serum triglyceride among group with remission of fatty liver [ ( - 0. 27 ± 0. 79 ) mmol/L ] , group without remission of fatty liver [ ( 0. 24 ± 1.88) mmol/L] , and group without fatty liver [(0. 11 ±1.07) mmol/L, F = 5. 58 , P < 0. 01 ]. Logistic regression analyses showed that the remission rate of fatty liver was correlated to BMI and serum triglyceride level at baseline and their changes during follow-up. Conclusion The remission rate of NAFLD is relative low. Its independent influencing factors include BMI and serum triglyceride at baseline as well as their changes.%目的 探讨上海宝钢职工非酒精性脂肪性肝病(NAFLD)的消退率及其影响因素.方法 回顾性分析1999年和2001年上海宝钢职工健康体检资料,选择无过量饮酒、基线时丙氨酸转氨酶正常以及乙肝表面抗原阴性者作为研究对象.结果 基线时440例NAFLD患者2年后影像学脂肪肝消退60例(13.6％,脂肪肝消退组),380例脂肪肝持续存在(脂肪肝未消退组),另有4867例两次体检都无脂肪肝的个体作为对照(无脂肪肝组).女性年龄＜ 50岁者脂肪肝消退率显著高于≥50岁者[33.3％ (3/9)对4.3％ (1/46),x2=4.969,P＜0.01].脂肪肝的消退率随着基线时体重指数(BMI)的增高而下降,体重正常、超重、肥胖和重度肥胖患者NAFLD消退率分别为18.2％、16.5％、13.5％、7.8％.随访期间,BMI差值在脂肪肝消退组(-0.26±1.18)、脂肪肝未消退组(0.39±1.13)、无脂肪肝组(0.50±1.29)之间差异有统计学意义(F=11.41,P＜0.01)；血清甘油三酯(TG)差值在脂肪肝消退组[(-0.27 ±0.79)mmol/L]、脂肪肝未消退组[(0.24±1.88) mmol/L]、无脂肪肝组[(0.11±1.07) mmol/L]之间差异亦有统计学意义(F=5.58,P＜0.01).多元回归分析显示,基线BMI和血清TG水平以及随访期间BMI、TG变化幅度与NAFLD的消退密切相关.结论 NAFLD的消退率相对较低,基线BMI和血清TG水平及其动态变化是影响NAFLD消退的独立因素.
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