目的 探讨高尿酸血症(HUA)与非酒精性脂肪性肝病(NAFLD)及颈动脉粥样硬化(CAS)的关系.方法 统计2 806例健康体检人群NAFLD、HUA的检出率.根据肝脏超声检查结果将入选对象分为NAFLD组和非脂肪肝组,观察两组的血尿酸水平及CAS情况,NAFLD组中不同尿酸水平患者颈动脉内膜情况.结果 NAFLD检出率为30.54％(857/2 806),HUA检出率为28.62％(803/2 806),两者男、女性检出率比较差异均有统计学意义(均P＜0.05).30岁后各年龄段高尿酸水平人群的NAFLD检出率均明显高于正常尿酸人群(均P＜0.05).NAFLD组HUA检出率(42.82％)、颈动脉内膜斑块检出率(20.19％)、颈动脉内膜增厚检出率(18.32％)均明显高于非脂肪肝组(22.37％、11.39％、13.03％)(均P＜0.05),而NAFLD组中HUA者的颈动脉斑块检出率(24.25％)、颈动脉内膜增厚检出率(22.07％)均高于正常尿酸者(17.14％、15.51％)(均P＜0.05).相关性分析显示,尿酸与BMI、SBP、DBP、TG、TC、LDL-C、ALT、AST及GGT均呈正相关(均P＜0.05),与HDL-C呈负相关(P＜0.05),尿酸为NAFLD的相关危险因素.结论 HUA与NAFLD密切相关,两者与CAS可能存在相关性.%Objective To investigate the correlation among hyperuricemia,nonalcoholic fatty liver disease (NAFLD) and carotid atherosclerosis.Methods Total 2806 individuals taking routine health checkup were enrolled in the study.The detection rate of nonalcoholic fatty liver disease and hyperuricemia were calculated statistically.Individuals were classified as NAFLD and non-NAFLD groups according toliver ultrasound examination.The serum uric acid levels were measured;the carotid atherosclerosis and carotid artery intima-media thicknening were detected.Results The detection rate of NAFLD and hyperuricemia was 30.54％ (857/2806) and 28.62％ (803/2806),respectively,the rate was significantly different between two genders (both P＜0.05).The detection rate of NAFLD in individuals with high uric acid level was significantly higher than that with normal uric acid in all age group after 30 years (all P＜0.05).The detection rate of hyperuricemia (42.82％),carotid artery plaque (20.19％) and carotid artery intima-media thickening (18.32％) in NAFLD group were all significantly higher than those in non-NAFLD group (22.37％,11.39％,13.03％,all P＜0.05).In NAFLD group,the detection rate of carotid artery plaque (24.25％) and carotid artery intima-media thickening (22.07％) in individuals with hyperuricemia were significantly higher than those with normal uric acid (17.14％,15.51％,both P＜0.05).Conclusion Hyperuricemia is closely associated with nonalcoholic fatty liver disease,and both may be related to carotid atherosclerosis.
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