社区老年高血压人群中血细胞参数与非酒精性脂肪肝的关系

王程成; 刘怀磊; 龚卫红

doi:10.16766/j.cnki.issn.1674-4152.001965

社区老年高血压人群中血细胞参数与非酒精性脂肪肝的关系

doi: 10.16766/j.cnki.issn.1674-4152.001965

上海市浦东新区曹路社区卫生服务中心，上海 201209

基金项目:

上海市浦东新区卫生系统社区适宜人才项目 PWRs2017-31

详细信息

通讯作者:
龚卫红，E-mail：gongweihong2009@126.com

中图分类号: R544.1 R575.5
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- 文章访问数: 202
- HTML全文浏览量: 99
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2021-05-27
- 网络出版日期: 2022-02-16

Association of blood cell parameters with non-alcoholic fatty liver disease in the elderly with hypertension

Caolu Community Health Service Center, Pudong New Area, Shanghai 201209, China

摘要

摘要: 目的探讨社区老年高血压人群中血细胞参数与非酒精性脂肪肝(NAFLD)的关系，以期为预测老年高血压人群非酒精性脂肪肝的发生提供参考。方法于2018年4—7月，以村/居委为单位，采取整群抽样方法抽取浦东新区某社区年龄≥60岁的老年高血压患者，建立社区健康体检档案并进行体格检查、实验室检查收集身高、体重、血压、血细胞参数等相关资料。采用多因素logistic回归分析研究血细胞参数与非酒精性脂肪肝的关系。结果老年高血压患者NAFLD检出率为63.29%(2 041/3 225)。非酒精性脂肪肝组淋巴细胞绝对值、淋巴细胞比率、单核细胞绝对值、中性粒细胞绝对值、白细胞计数、红细胞计数、红细胞比容、血红蛋白、平均血红蛋白浓度、血小板计数水平均高于正常组(均P < 0.05)，非酒精性脂肪肝组中性粒细胞比率、红细胞分布宽度、平均红细胞体积水平均低于正常组(均P < 0.05)。调整性别、年龄、体重指数和空腹血糖后，红细胞分布宽度过低，单核细胞绝对值、淋巴细胞绝对值、红细胞计数、血红蛋白过高是非酒精性脂肪肝的危险因素(均P < 0.05)。结论老年高血压人群中，红细胞分布宽度、淋巴细胞绝对值、红细胞计数、血红蛋白、单核细胞绝对值水平与非酒精性脂肪肝相关，这可能为预测老年高血压人群非酒精性脂肪肝的发生提供新的思路。
- 非酒精性脂肪肝 /
- 高血压 /
- 血细胞 /
- 横断面研究
Abstract: Objective This study aimed to investigate the relationship between blood cell parameters and non-alcoholic fatty liver disease (NAFLD) in the elderly with hypertension and provide scientific evidence for the prevention and control of NAFLD in elderly hypertensive patients. Methods The cluster sampling method was adopted to select elderly people aged over 60 years who were diagnosed with hypertension from April to July 2018 by taking the village or committee as a unit. After establishing community health examination files, physical examination and laboratory examination were conducted to collect blood cell parameters and other data. Multivariate logistic regression was used to analyse the relationship between blood cell parameters and NAFLD. Results The detection rate of NAFLD in elderly patients with hypertension was 63.29% (2 041/3 225). The level of absolute lymphocyte, leukomonocyte, absolute monocyte, absolute neutrophil count, white blood cell count, red blood cell count, haematocrit, haemoglobin, mean corpuscular haemoglobin concentration and platelet count in the NAFLD group was higher than that in the normal group (all P < 0.05). The level of neutrophile granulocyte, red blood cell distribution width and mean corpuscular volume in the NAFLD group was lower than that in the normal group (all P < 0.05). After adjusting for gender, age, BMI and fasting glucose, red blood cell distribution width was negatively associated with NAFLD, and absolute lymphocyte, absolute monocyte, haemoglobin and red blood cell count were positively associated with NAFLD (all P < 0.05). Conclusion Our results suggest that red cell distribution width, absolute lymphocyte, red blood count, absolute monocyte and haemoglobin were associated with NAFLD, which may provide a new way to prevent and control NAFLD in elderly hypertensive patients.
- Non-alcoholic fatty liver disease /
- Hypertension /
- Blood cells /
- Cross-sectional studies

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表 1 2组高血压患者一般特征比较

组别	例数	性别(例)		年龄(x ±s，岁)	BMI(x ±s)	空腹血糖(x ±s)
组别	例数	男性	女性	年龄(x ±s，岁)	BMI(x ±s)	空腹血糖(x ±s)
正常组	1 184	401	783	70.69±7.55	23.67±5.41	5.20±1.37
NAFLD组	2 041	800	1 241	68.67±6.46	26.39±5.96	5.76±1.95
统计量		9.102^a		7.712^b	-12.931^b	-9.408^b
P值		0.003		< 0.001	< 0.001	< 0.001
注：^a为χ²值，^b为t值。

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表 2 2组老年高血压患者白细胞参数比较(x ±s)

组别	例数		白细胞计数(×10⁹/L)	嗜碱性粒细胞绝对值(×10⁹/L)	嗜碱性粒细胞比率(%)	嗜酸性粒细胞绝对值(×10⁹/L)	嗜酸性粒细胞比率(%)
正常组	1 184		6.49±1.71	0.02(0.01, 0.03)	0.30(0.20, 0.50)	0.10(0.06, 0.17)	1.60(1.00, 2.60)
NAFLD组	2 041		6.92±1.68	0.02(0.01, 0.03)	0.30(0.20, 0.50)	0.11(0.07, 0.18)	1.70(1.10, 2.60)
统计量			-6.665^a	-0.670^b	0.019^b	-3.289^b	-1.066^b
P值			< 0.001	0.208	0.985	0.001	0.286

组别	例数	淋巴细胞绝对值(×10⁹/L)	淋巴细胞比率(%)	单核细胞绝对值(×10⁹/L)	单核细胞比率(%)	中性粒细胞绝对值(×10⁹/L)	中性粒细胞比率(%)
正常组	1 184	2.25±0.74	35.24±8.72	0.36(0.27, 0.47)	5.55±2.35	3.72±1.27	5.67±8.76
NAFLD组	2 041	2.49±0.76	36.46±8.43	0.39(0.29, 0.49)	5.57±2.32	3.88±1.27	5.56±8.39
统计量		-8.629^a	-3.881^a	-4.299^b	-0.243^a	-3.552^a	3.798^a
P值		< 0.001	< 0.001	< 0.001	0.808	< 0.001	< 0.001
注：^a为t值，^b为U值。

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表 3 2组老年高血压患者红细胞参数比较(x ±s)

组别	例数	红细胞计数(×10¹²/L)	红细胞分布宽度(%)	红细胞比容(%)	血红蛋白(g/L)	平均血红蛋白量(pg)	平均血红蛋白浓度(g/L)	平均红细胞体积(fL)
正常组	1 184	4.49±0.41	13.76±0.92	42.10(39.80, 44.70)	135.42±12.76	30.17±1.53	320.62±12.05	94.13±4.97
NAFLD组	2 041	4.67±0.40	13.64±0.88	43.40(41.20, 46.00)	140.74±12.40	30.15±1.47	322.60±13.80	93.465±4.90
统计量		-12.127^a	3.615^a	-9.865^b	-11.604^a	0.283^a	-4.101^a	3.709^a
P值		< 0.001	< 0.001	< 0.001	< 0.001	0.777	< 0.001	< 0.001
注：^a为t值，^b为U值。

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表 4 2组老年高血压患者血小板参数比较(x ±s)

组别	例数	平均血小板体积(fL)	血小板压积(%)	血小板分布宽度(fL)	大型血小板比率(%)	血小板计数(109/L)
正常组	1 184	10.93±0.85	0.23(0.19, 0.27)	13.55±1.96	32.72±7.19	211.83±53.38
NAFLD组	2 041	10.91±0.83	0.24(0.20, 0.27)	13.60±1.89	32.51±7.00	217.65±52.85
统计量		0.882^a	-3.653^b	-0.771^a	0.788^a	-3.004^a
P值		0.378	< 0.001	0.441	0.431	0.003
注：^a为t值，^b为U值。

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表 5 血细胞参数与非酒精性脂肪肝的多因素分析

变量	B	SE	Wald χ²	P值	OR(95% CI)
红细胞分布宽度	-0.106	0.043	5.997	0.014	0.900(0.827~0.979)
红细胞计数	0.465	0.184	6.376	0.012	1.592(1.110~2.284)
单核细胞绝对值	0.045	0.017	6.682	0.010	1.046(1.011~1.082)
淋巴细胞绝对值	0.356	0.056	40.255	< 0.001	1.428(1.279~1.594)
血红蛋白	0.018	0.006	7.766	0.005	1.018(1.005~1.031)
BMI	0.076	0.007	107.084	< 0.001	1.078(1.063~1.094)
性别	0.233	0.100	5.378	0.020	1.262(1.037~1.537)
年龄	-0.027	0.006	21.091	< 0.001	0.973(0.962~0.985)
空腹血糖	0.179	0.027	44.047	< 0.001	1.196(1.135~1.262)

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