芜湖市不同性别企业员工代谢相关脂肪性肝病现况及影响因素分析

职业与健康 ›› 2025, Vol. 41 ›› Issue (14): 1924-1930.

芜湖市不同性别企业员工代谢相关脂肪性肝病现况及影响因素分析

武艳¹, 张先翠^2a, 徐艳^2b, 王江波^2c, 李磊^2d, 王箴³

1.皖南医学院第二附属医院护理部,安徽芜湖 241000;
2.皖南医学院第一附属医院a健康管理中心,b人事科,c甲乳外科,d创面修复外科,安徽芜湖 241001;
3.泰康同济（武汉）医院全科医学科,湖北武汉 430050

收稿日期:2024-10-31 修回日期:2024-11-18 出版日期:2025-07-15 发布日期:2025-12-12
通信作者: 徐艳,主治医师,E-mail：1019396312@qq.com
作者简介:武艳,女,在读硕士研究生,研究方向为慢病管理与急危重症护理。
基金资助:
国家自然科学基金青年科学基金项目（823015751003724）; 安徽省高等学校省级质量工程项目（2022zyxwjxalk164）; 安徽省高等学校科学研究项目（KJ2021ZD0099; 2022 AH040165）

Analysis of the status and influencing factors of metabolism-related fatty liver disease among employees of different genders in enterprises in Wuhu City

WU Yan¹, ZHANG Xiancui^2a, XU Yan^2b, WANG Jiangbo^2c, LI Lei^2d, WANG Zhen³

1. The Nursing Department of the Second Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241000,China;
2. a Health Management Center,b Personnel Department,c Chest and Breast Surgery Department,d Wound Repair Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241000,China;
3. The General Practice Department of Taikang Tongji（Wuhan） Hospital,Wuhan,Hubei 430050,China

Received:2024-10-31 Revised:2024-11-18 Online:2025-07-15 Published:2025-12-12
Contact: XU Yan,Attending physician,E-mail：1019396312@qq.com

摘要/Abstract

摘要： 目的分析芜湖市不同性别企业员工代谢相关脂肪性肝病（metabolically associated fatty liver disease,MAFLD）现状,明确其危险因素,探讨各指标预测价值。方法 2022年6—11月选取来自7所不同大型企业、在芜湖市某医院健康管理中心的29 684例健康检查者为研究对象,通过腹部超声检查和体格检查评估MAFLD,分为非MAFLD组（19 812例）和MAFLD组（9 872例）,对不同性别MAFLD患病情况及特点进行分析;探讨MAFLD不同性别人群影响因素时采用多因素logistic回归分析,采用受试者工作特征曲线（receiver operating characteristic curve,ROC）分析各指标的预测价值,计算ROC曲线下面积（AUC）、灵敏度、特异度。结果 29 684名研究对象,平均年龄（45.18±13.57）岁,总患病率33.26%。其中男性16 171人,占54.50%,男性MAFLD患者7 648例,患病率47.29%;女性13 513人,占45.50%,女性MAFLD患者2 224例,患病率16.46%,对MAFLD不同性别人群患病率比较,差异有统计学意义（χ²=3 153.570,P<0.01）。多因素logistic回归分析显示,体质量、三酰甘油、空腹血糖、低密度脂蛋白胆固醇、总胆固醇、高密度脂蛋白胆固醇、天冬氨酸/丙氨酸转氨酶均是企业员工MAFLD患者的共同影响因素（均P<0.05）,其中,舒张压、总胆红素、天冬氨酸转氨酶、尿酸均是男性MAFLD的独立影响因素（均P<0.05）;年龄、总蛋白、白蛋白均是女性MAFLD的独立影响因素（均P<0.05）。ROC曲线分析结果显示,体质量、三酰甘油、体质量联合三酯甘油对MAFLD患者的预测价值最高。结论芜湖市企业员工男性和女性发生MAFLD的影响因素略有不同,但体质量、三酰甘油、空腹血糖、低密度脂蛋白胆固醇、总胆固醇、高密度脂蛋白胆固醇、天冬氨酸/丙氨酸转氨酶均是影响因素。在不同性别的人群中,体质量联合三酰甘油均具有较高的预测价值,可预测芜湖市企业员工MAFLD的发生。

关键词: 代谢相关性脂肪肝, 企业员工, 性别因素, 影响因素

Abstract: Objective To analyze the status quo of metabolism-related fatty liver disease（MAFLD） in employees of different genders in Wuhu City,identify its risk factors,and explore the predictive value of each index. Methods A total of 29 684 patients from seven large enterprises who underwent occupational health examination in the health management center of a hospital in Wuhu City from June to November 2022 were selected as the study objects. MAFLD was evaluated by abdominal ultrasonography and physical examination,and was divided into non-MAFLD group（19 812 cases） and MAFLD group（9 872 cases）. The prevalence and characteristics of MAFLD in different genders were analyzed. Multivariate logistic regression analysis was used to explore the influencing factors of MAFLD population with different genders. The predictive value of each indicator was analyzed by receiver operating characteristic（ROC） curve,and the area under ROC curve（AUC）,sensitivity and specificity were calculated. Results The average age of 29 684 subjects was （45.18±13.57）years,and the total prevalence was 33.26%.There were 16 171 males（54.50%）and 7 648 males with MAFLD（prevalence 47.29%）.There were 13 513 females（45.50%）and 2 224 females with MAFLD,with a prevalence rate of 16.46%.There was a statistically significance difference in the prevalence of MAFLD between different genders（χ²=3 153.570,P<0.01）. Multivariate logistic regression analysis showed that body mass,triglycerides,fasting blood glucose,low density lipoprotein,total cholesterol,high density lipoprotein,and aspartate/alanine aminotransferase were the common influencing factors for MAFLD patients among enterprise employees（all P<0.05）. Among them,diastolic blood pressure,total bilirubin,aspartate and uric acid were independent influencing factors of MAFLD in male physical examination subjects（all P<0.05）. Age,total protein and albumin were the independent influencing factors of female MAFLD（all P<0.05）. ROC curve analysis results showed that body mass,triacylglycerol and body mass combined triacylglycerol had the highest predictive value for MAFLD patients. Conclusion The factors affecting the occurrence of MAFLD in male and female employees in Wuhu City were slightly different,but body weight,triglyceride,fasting blood glucose,low density lipoprotein,total cholesterol,high density lipoprotein,and aspartate/alanine aminotransferase were both influencing factors. Anong people of different genders,body mass combined with triglyceride has high predictive value and can predict the occurrence of MAFLD in Wuhu employees.

Key words: Metabolism-related fatty liver, Enterprise employee, Gender factors, Influencing factors

中图分类号:

R181.3

武艳, 张先翠, 徐艳, 王江波, 李磊, 王箴. 芜湖市不同性别企业员工代谢相关脂肪性肝病现况及影响因素分析. [J]职业与健康, 2025, 41(14): 1924-1930.

WU Yan, ZHANG Xiancui, XU Yan, WANG Jiangbo, LI Lei, WANG Zhen. Analysis of the status and influencing factors of metabolism-related fatty liver disease among employees of different genders in enterprises in Wuhu City. [J]OCCUPATION AND HEALTH, 2025, 41(14): 1924-1930.

参考文献

[1] SHIHA G,KORENJAK M,ESKRIDG W,et al.Redefining fatty liver disease:an international patient perspective[J].Lancet Gastroenterol Hepatol,2021,6(1):73-79.
[2] LIANG Y,Chen H,LIU Y,et al.Association of MAFLD with diabetes,chronic kidney disease,and cardiovascular disease:A 4.6-year cohort study in China[J]. J Clin Endocrinol Metab,2022,107(1):88-97.
[3] FAN J,LUO S,Ye Y,et al.Prevalence and risk factors of metabolic associated fatty liver disease in the contemporary South China population[J].Nutr Metab,2021,18(1):82.
[4] ESLAM M,SARIN S K,WONG V W,et al.The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic-associated fatty liver disease[J].Hepatol Int,2020,14(6):889-919.
[5] LEE H,LEE Y H,KIM S U,et al.Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk:A Nationwide Cohort Study[J].Clin Gastroenterol Hepatol,2021,19(10):2138-2147.
[6] HUANG Q,ZOU X,WEN X,et al.NAFLD or MAFLD:Which Has Closer Association With All-Cause and Cause-Specific Mortality[J]. Front Med,2021,8:693507.
[7] 中华医学会超声医学分会,中国研究型医院学会肿瘤介入专业委员会,国家卫生和健康委员会能力建设和继续教育中心超声医学专家委员会.肝病超声诊断指南[J].中华肝脏病杂志,2021,29(5):385-402.
[8] POPKIN B M,NG S W.The nutrition transition to a stage of high obesity and noncommunicable disease prevalence dominated by ultra-processed foods is not inevitable[J].Obes Rev,2022,23(1):e13366.
[9] CHIA A,ONG J,BUNDELE A,et al.Social entrepreneurship in obesity prevention:A scoping review[J].Obes Rev,2022,23(3):e13378.
[10] WELLS JC,SAWAYA AL,WIBAEK R,et al.The double burden of malnutrition:Aetiological pathways and consequences for health[J].Lancet,2020,395(10217):75-88.
[11] ZHOU J,ZHOU F,WANG W,et al.Epidemiological features of NAFLD from 1999 to 2018 in China[J]. Hepatology,2020,71(5):1851-1864.
[12] ESTES C,ANSTEE QM,ARIAS-LOSTE M T,et al.Modeling NAFLD disease burden in China,France,Germany,Italy,Japan,Spain,United Kingdom,and the United States for the period 2016-2030[J].J Hepatol,2018,69(4):896-904.
[13] LEI F,QIN J J,SONG X,et al.The prevalence of MAFLD and its association with atrial fibrillation in a nationwide health check-up population in China[J].Front Endocrinol,2022,13:1007171.
[14] 王珊,张健,蒋晓忠,等.非肥胖人群的腰围轨迹与新发非酒精性脂肪肝的相关性[J].中华流行病学杂志,2020,41(6):824-828.
[15] SHAUNAK M,BYRNE CD,DAVIS N,et al.Non-alcoholic fatty liver disease and childhood obesity[J].Arch Dis Child,2021,106(1):3-8.
[16] LONARDO A,NASCIMBENI F,BALLESTRI S,et al.Sex differences in nonalcoholic fatty liver disease:state of the art and identification of research gaps[J].Hepatology,2019,70(4):1457-1469.
[17] LAZARUS J V,MARK H E,ANSTEE Q M,et al.Advancing the global public health agenda for NAFLD:A consensus statement[J].Nat Rev Gastroenterol Hepatol,2022,19(1):60-78.
[18] LAZARUS J V,MARK H E,COLOMBO M,et al.A sustainable development goal framework to guide multisectoral action on NAFLD through a societal approach[J].Aliment Pharmacol Ther,2022,55(2):234-243.
[19] ESLAM M,SARIN S K,WONG V W,et al.The Asian Pacific Association for the study of the Liver clinical practice guidelines for the diagnosis and management of metabolic-associated fatty liver disease[J].Hepatol Int,2020,14(6):889-919.
[20] VILAR-GOMEZ E,MARTINEZ-PEREZ Y,CALZADILLA-BERTOT L,et al.Weight Loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis[J].Gastroenterology,2015,149(2):367-378.
[21] ZHOU X D,CAI J,TARGHER G,et al.Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention[J].Cardiovasc Diabetol,2022,21(1):270.