脂肪肝与腔隙性脑梗死的关系分析

黄婴婷; 戴标

doi:10.3969/j.issn.1001-5256.2018.12.022

脂肪肝与腔隙性脑梗死的关系分析

DOI: 10.3969/j.issn.1001-5256.2018.12.022

黄婴婷,
戴标

福建医科大学附属宁德市医院神经内科

基金项目:

福建省卫生厅青年人才项目(2013-2-158)；

详细信息

中图分类号: R575.5;R743.3
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出版历程
- 出版日期: 2018-12-20

Association between fatty liver disease and lacunar infarction

Research funding:

摘要

摘要:
目的探讨脂肪肝是否腔隙性脑梗死的危险因素。方法回顾性分析2007年-2017年在宁德市医院住院的457例腔隙性脑梗死患者（腔隙性脑梗死组）以及同期住院的120例对照患者（对照组）的临床资料,分析脂肪肝是否为腔隙性脑梗死发生的危险因素。计数资料2组间比较采用χ2检验,计量资料2组间比较用t检验。腔隙性脑梗死的危险因素筛选采用单因素及多因素回归分析。结果腔隙性脑梗死组患者脂肪肝所占比例高于对照组（60. 39%vs 39. 17%,χ2=17. 379,P <0. 001）。多因素回归分析结果显示,校正了年龄、性别、吸烟、饮酒、高血压及糖尿病后,脂肪肝是腔隙性脑梗死的独立危险因素[比值比（OR）=1. 96,95%可信区间（95%CI）:1. 21～3. 02,P=0. 003]。但肥胖与脂肪肝具有明显的相互作用（P=0. 001）。进一步回归分析结果显示,在非肥胖亚组,脂肪肝是腔隙性脑梗死的独立危险因素（OR=3. 29,95%CI:1. 55～7. 23,P <0. 001）;在肥胖亚组脂肪肝不是腔隙性脑梗死的独立危险因素（P=0. 532）,年龄（OR=6. 67,95%...
- 脂肪肝 /
- 脑梗死 /
- 危险因素
Abstract:
Objective To investigate whether fatty liver disease is a risk factor for lacunar infarction. Methods A retrospective analysis was performed for the clinical data of 457 patients with lacunar infarction (lacunar infarction group) and 120 control patients, who were hospitalized in our hospital from 2007 to 2017, to analyze whether fatty liver disease is a risk factor for lacunar infarction. The chi-square test was used for comparison of categorical data between groups, and the t-test was used for comparison of continuous data between groups. Univariate and multivariate regression analyses were used to screen out the risk factors for lacunar infarction. Results The lacunar infarction group had a significantly higher incidence rate of fatty liver disease than the control group (60. 39% vs 39. 17%, χ2= 17. 379, P < 0. 001) .The multivariate regression analysis showed that after adjustment for age, sex, smoking, drinking, hypertension, and diabetes, fatty liver disease was an independent risk factor for lacunar infarction (odds ratio [OR]= 1. 96, 95% confidence interval [CI]: 1. 21-3. 02, P =0. 003) . There was a significant interaction between obesity and fatty liver disease (P = 0. 001) . Non-obese fatty liver disease was an independent risk factor for lacunar infarction (OR = 3. 29, 95% CI: 1. 55-7. 23, P < 0. 001) ; however, in the obese subgroup, obese fatty liver disease was not an independent risk factor for lacunar infarction (P = 0. 532) , Age (OR = 6. 67, 95% CI: 1. 98 ～ 121. 56, P < 0. 001) , hypertension (OR = 6. 38, 95% CI: 5. 12 ～ 12. 06, P < 0. 001) were independent risk factors for lacunar infarction. Conclusion Non-obese fatty liver disease is an independent risk factor for lacunar infarction.
- fatty liver /
- brain infarction /
- risk factors

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参考文献(23)

[1] MOK V, KIM JS. Prevention and management of cerebral small vessel disease[J]. J Stroke, 2015, 17 (2) :111-122.

[2] TAKAO M, KOTO A. Pathology of lacunar infarction[J]. Nippon Rinsho, 2006, 64 (Suppl 8) :134-138.

[3] ARBOIX A, MARTI-VILALTA JL. Lacunar stroke[J]. Expert Rev Neurother, 2009, 9 (2) :179-196.

[4] DEARBORN JL, SCHNEIDER AL, SHARRETT AR, et al. Obesity, insulin resistance, and incident small vessel disease on magnetic resonance imaging:Atherosclerosis risk in communities study[J].Stroke, 2015, 46 (11) :3131-3136.

[5] LEE JE, SHIN DW, YUN JM, et al. Insulin resistance is a risk factor for silent lacunar infarction[J]. Stroke, 2016, 47 (12) :2938-2944.

[6] WU JJ. Association between drinking and lacunar infarction[J].Mod J Integr Tradit Chin West Med, 2014, 23 (5) :542-543. (in Chinese) 吴建军.饮酒与腔隙性脑梗死的关系探讨[J].现代中西医结合杂志, 2014, 23 (5) :542-543.

[7] SALAMONE F, BUGIANESI E. Nonalcoholic fatty liver disease:The hepatic trigger of the metabolic syndrome[J]. J Hepatol, 2010, 53 (6) :1146-1147.

[8] WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies[J]. Lancet, 2004, 363 (9403) :157-163.

[9] Writing Group of 2010 Chinese Guidelines for the Management of Hypertension. 2010 Chinese guidelines for the management of hypertension[J]. Chin J Cardiol, 2011, 39 (7) :579-616. (in Chinese) 中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志, 2011, 39 (7) :579-616.

[10] Chinese Society of Diabetes, Chinese Medical Association. Chinese guidelines for the prevention and treatment of type 2 diabetes (2013version) [J]. Chin J Diabetes, 2014, 6 (7) :447-498. (in Chinese) 中华医学会糖尿病学分会.中国2型糖尿病防治指南 (2013版) [J].中华糖尿病杂志, 2014, 6 (7) :447-498.

[11] Joint committee for developing Chinese guidelines on prevention and treatment of dyslipidemia in adults. Chinese guidelines on prevention and treatment of dyslipidemia in adults[J]. Chin J Cardiol, 2007, 35 (5) :390-419. (in Chinese) 中国成人血脂异常防治指南制订联合委员会.中国成人血脂异常防治指南[J].中华心血管病杂志, 2007, 35 (5) :390-419.

[12] YANG GH, MA JM, LIU N, et al. Smoking and passive smoking in Chinese, 2002[J]. Clin J Epidemiol, 2005, 26 (2) :77-83. (in Chinese) 杨功焕, 马杰民, 刘娜, 等.中国人群2002年吸烟和被动吸烟的现状调查[J].中华流行病学杂志, 2005, 26 (2) :77-83.

[13] KWAK MS, KIM KW, SEO H, et al. Non-obese fatty liver disease is associated with lacunar infarct[J]. Liver Int, 2018, 38 (7) :1292-1299.

[14] KIM SU, SONG D, HEO JH, et al. Liver fibrosis assessed with transient elastography is an independent risk factor for ischemic stroke[J]. Atherosclerosis, 2017, 260:156-162.

[15] HAMAGUCHI M, KOJIMA T, TAKEDA N, et al. Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease[J].World J Gastroenterol, 2007, 13 (10) :1579-1584.

[16] ADAMS LA, ANSTEE QM, TILG H, et al. Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases[J]. Gut, 2017, 66 (6) :1138-1153.

[17] MOSHAYEDI H, AHRABI R, MARDANI A, et al. Association between non-alcoholic fatty liver disease and ischemic stroke[J].Iran J Neurol, 2014, 13 (3) :144-148.

[18] YING I, SAPOSNIK G, VERMEULEN MJ, et al. Nonalcoholic fatty liver disease and acute ischemic stroke[J]. Epidemiology, 2011, 22 (1) :129-130.

[19] CRUZ ACD, BUGIANESI E, GEORGE J, et al. 379 characteristics and long-term prognosis of lean patients with nonalcoholic fatty liver disease[J]. Gastroenterology, 2014, 146 (5 Suppl) :S-909.

[20] HAMAGUCHI M, KOJIMA T, FUKUDA T, et al. Nonoverweight nonalcoholic fatty liver disease and incident cardiovascular disease:A post hoc analysis of a cohort study[J]. Medicine (Baltimore) , 2017, 96 (18) :e6712.

[21] BYRNE CD, TARGHER G. Ectopic fat, insulin resistance, and nonalcoholic fatty liver disease:Implications for cardiovascular disease[J].Arterioscler Thromb Vasc Biol, 2014, 34 (6) :1155-1161.

[22] LI JX, XU XJ, TANG Q, et al. The relation between carotid atherosclerosis and lacunar infarction in hypertensive patients[J]. Chin J Geriatr Heart Brain Vessel Dis, 2007, 9 (8) :538-540. (in Chinese) 李金贤, 徐新娟, 唐琪, 等.高血压患者颈动脉粥样硬化病变与腔隙性脑梗死的关系[J].中华老年心脑血管病杂志, 2007, 9 (8) :538-540.

[23] ARBOIX A, BLANCO-ROJAS L, OLIVERES M, et al. Clinical characteristics of acute lacunar stroke in women:Emphasis on gender differences[J]. Acta Neurol Belg, 2014, 114 (2) :107-112.

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