我们的网站为什么显示成这样?

可能因为您的浏览器不支持样式,您可以更新您的浏览器到最新版本,以获取对此功能的支持,访问下面的网站,获取关于浏览器的信息:

|本期目录/Table of Contents|

糖尿病与脂肪肝对绝经女性胆石症患病的交互作用(PDF)

《现代预防医学》[ISSN:1003-8507/CN:51-1365/R]

期数:
2022年14期
页码:
2559-2564
栏目:
儿少卫生与妇幼保健
出版日期:
2022-07-30

文章信息/Info

Title:
The interaction effect between diabetes and fatty liver on the prevalence of cholelithiasis in menopausal women
作者:
刘云涛覃子秀关菡王子云洪峰曾奇兵
贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 550025
Author(s):
LIU Yun-tao QIN Zi-xiu GUAN Han WANG Zi-yun HONG Feng ZENG Qi-bing
The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, Guizhou 550025, China
关键词:
胆石症糖尿病脂肪肝交互作用绝经
Keywords:
Cholelithiasis Diabetes Fatty liver Interaction effect Menopause
分类号:
R575.62
DOI:
10.20043/j.cnki.MPM.202203214
文献标识码:
A
摘要:
目的 探讨糖尿病与脂肪肝的交互作用对绝经女性胆石症患病的影响。方法 研究采用多阶段分层整群抽样方法抽取苗族、侗族绝经女性作为研究对象,纳入符合条件的研究对象共3 938人。采用SPSS25.0软件进行Mann - Whitney U检验、χ2检验、单因素和多因素logistic回归分析;同时运用相乘模型和相加模型探讨糖尿病与脂肪肝的交互作用对绝经女性胆石症患病的影响。结果 本次3 938名绝经女性中,平均年龄为59.51岁,胆石症检出率为17.01%,糖尿病检出率为9.09%,脂肪肝检出率为19.86%,糖尿病合并脂肪肝检出率为4.06%。多因素logistic回归结果显示,糖尿病(OR = 1.715, 95%CI:1.325~2.220)和脂肪肝(OR = 1.438, 95%CI:1.162~1.780)均与绝经女性胆石症的患病风险有关。交互作用分析结果显示,糖尿病与脂肪肝对绝经女性胆石症的患病不存在相乘交互作用(OR = 1.605,95%CI:0.951~2.707),结果无统计学意义;但糖尿病与脂肪肝对绝经女性胆石症的患病存在相加交互作用,糖尿病合并脂肪肝者的患病风险高于无糖尿病且无脂肪肝者(OR = 2.905,95%CI:2.040~4.138),其相加交互作用评价指标RERI(95%CI)、AP(95%CI)和SI(95%CI)分别为1.216(0.115~2.316)、0.418(0.148~0.688)和2.760(1.043~7.305),结果有统计学意义。结论 在绝经女性中,糖尿病和脂肪肝均与胆石症存在关联,二者对增加胆石症患病风险可能存在协同作用。
Abstract:
Objective To explore the interaction effect between diabetes and fatty liver on cholelithiasis in postmenopausal women. Methods The multistage stratified cluster sampling method was used to select the Miao and Dong postmenopausal women as the research objects, and a total of 3 938 eligible subjects were included in the current study. The Mann-Whitney U test, Chi-square test, univariate logistic regression and multivariate logistic regression were used to analyze the data by using the SPSS 25.0 statistical software. In addition, multiplicative and additive models were utilized to explore the interaction effect between diabetes and fatty liver on cholelithiasis in postmenopausal women. Results Among the 3 938 postmenopausal women, the average age was 59.51 years old. The detection rate of cholelithiasis, diabetes, fatty liver and diabetes plus fatty liver was 17.01%, 9.09%, 19.86%, and 4.06%, respectively. Multivariate logistic regression analysis results showed diabetes (OR=1.715, 95%CI: 1.325-2.220) and fatty liver (OR=1.438, 95%CI: 1.162-1.780) were associated with the risk of cholelithiasis in postmenopausal women. There was no multiplicative interaction between diabetes and fatty liver on cholelithiasis (OR=1.605, 95%CI: 0.951-2.707), but there was additive interaction between diabetes and fatty liver on cholelithiasis in postmenopausal women. The risk of cholelithiasis in postmenopausal women with diabetes plus fatty liver was significantly higher than that in postmenopausal women without diabetes and fatty liver (OR=2.905, 95%CI: 2.040-4.138). RERI (95%CI), AP (95%CI), and SI (95%CI) were 1.216 (0.115-2.316), 0.418(0.148-0.688), and 2.760 (1.043-7.305), respectively. Conclusion In menopausal women, both diabetes mellitus and fatty liver are associated with cholelithiasis, and there may be a synergistic effect of both on increasing the risk of cholelithiasis.

参考文献/References

[ 1 ]Su Z, Gong Y, Liang Z. Prevalence of gallstone in Mainland China: A meta - analysis of cross - sectional studies[J]. Clinics and Research in Hepatology and Gastroenterology, 2020, 44(4): e69 - e71.
[ 2 ]European Association for the Study of the Liver. EASL clinical practice guidelines on the prevention, diagnosis and treatment of gallstones[J]. Journal of Hepatology, 2016, 65(1): 146 - 181.
[ 3 ]王成,孙培龙.胆石症成因的研究进展[J].肝胆外科杂志,2018,26(2):157 - 160.Wang C, Sun PL. Research progress on the cause of gallstone disease[J]. Journal of Hepatobiliary Surgery, 2018, 26(2): 157 - 160.
[ 4 ]Halldestam I, Enell EL, Kullman E, et al. Development of symptoms and complications in individuals with asymptomatic gallstones[J]. The British Journal of Surgery, 2004, 91(6): 734 - 738.
[ 5 ]Pak M, Lindseth G. Risk factors for cholelithiasis[J]. Gastroenterology Nursing, 2016, 39(4): 297 - 309.
[ 6 ]聂婵,袁质平,杨婷婷,等.侗族女性胆结石流行现况及其影响因素分析[J].现代预防医学,2021,48(19):3466 - 3470.Nie C, Yuan ZP, Yang TT, et al. Prevalence and risk factors of gallstone disease among Dong women[J]. Modern Preventive Medicine, 2021, 48(19): 3466 - 3470.
[ 7 ]吴水琳,覃家莉,李勇,等.女性绝经前后代谢综合征与胆结石发病情况关联[J].中华疾病控制杂志,2021,25(6):686 - 691.Wu SL, Qin JL, Li Y, et al. The association between metabolic syndrome and the risk of gallstones among premenopausal and postmenopausal women[J]. Chinese Journal of Disease Control & Prevention, 2021, 25(6): 686 - 691.
[ 8 ]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)(上)[J].中国实用内科杂志,2021,41(8):668 - 695.Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China(2020 edition)(Part 1)[J]. Chinese Journal of Practical Internal Medicine, 2021, 41(8): 668 - 695.
[ 9 ]Fan JG, Farrell GC. Epidemiology of non - alcoholic fatty liver disease in China[J]. Journal of Hepatology, 2009, 50(1): 204 - 210.
[ 10 ]金春花,范能光,张文,等.2型糖尿病患者合并非酒精性脂肪肝与胰岛素抵抗的相关性[J].热带医学杂志,2011,11(1):65 - 67, 73.Jin CH, Fan NG, Zhang W, et al. Non - alcoholic fatty liver disease in patients with type 2 diabetes is closely associated with insulin resistance[J]. Journal of Tropical Medicine, 2011, 11(1): 65 - 67, 73.
[ 11 ]葛晓春,王英南,刘晓燕,等.血脂康胶囊治疗绝经后女性2型糖尿病合并非酒精性脂肪肝的临床观察[J].中国药房,2016,27(33):4641 - 4643.Ge XC, Wang YN, Liu XY, et al. Clinical observation of Xuezhikang capsule in the treatment of post - menopause patients with type 2 diabetes and nonalcoholic fatty liver disease[J]. China Pharmacy, 2016, 27(33): 4641 - 4643.
[ 12 ]Aune D, Vatten LJ. Diabetes mellitus and the risk of gallbladder disease: A systematic review and meta - analysis of prospective studies[J]. Journal of Diabetes and Its Complications, 2016, 30(2): 368 - 373.
[ 13 ]Liu J, Lin HY, Zhang CQ, et al. Non - alcoholic fatty liver disease associated with gallstones in females rather than males: a longitudinal cohort study in Chinese urban population[J]. BMC Gastroenterology, 2014, 14(1): 213.
[ 14 ]Nakeeb A, Comuzzie AG, Al - Azzawi H, et al. Insulin resistance causes human gallbladder dysmotility[J]. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract, 2006, 10(7): 940 - 948; discussion 948 - 9.
[ 15 ]Biddinger SB, Haas JT, Yu BB, et al. Hepatic insulin resistance directly promotes formation of cholesterol gallstones[J]. Nature Medicine, 2008, 14(7): 778 - 782.
[ 16 ]Festi D, Dormi A, Capodicasa S, et al. Incidence of gallstone disease in Italy: Results from a multicenter, population - based Italian study(the MICOL project)[J]. World Journal of Gastroenterology, 2008, 14(34): 5282 - 5289.
[ 17 ]梁明杨,魏垚臣,王一鸣,等.空腹血糖水平与胆石症发病风险的关系[J].临床肝胆病杂志,2019,35(11):2517 - 2522.Liang MY, Wei YC, Wang YM, et al. Association between fasting blood glucose and the risk of cholelithiasis[J]. Journal of Clinical Hepatology, 2019, 35(11): 2517 - 2522.
[ 18 ]Zhao X, Hong F, Yin J, et al. Cohort profile: the China Multi - Ethnic cohort (CMEC) study[J]. International Journal of Epidemiology, 2021, 50(3): 721 - 721l.
[ 19 ]中华医学会肝病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗指南(2010年修订版)[J].现代医药卫生,2011,27(5):641 - 644.The Chinese National Workshop on Fatty Liver and Alcoholic Liver disease for the Chinese Liver Disease Association. Guidelines for management of nonalcoholic fatty liver disease: an updated and revised edition[J]. Modern Medicine & Health, 2011, 27(5): 641 - 644.
[ 20 ]Du H, Bennett D, Li L, et al. Physical activity and sedentary leisure time and their associations with BMI, waist circumference, and percentage body fat in 0.5 million adults: the China Kadoorie Biobank study[J]. The American Journal of Clinical Nutrition, 2013, 97(3): 487 - 496.
[ 21 ]Andersson T, Alfredsson L, K■llberg H, et al. Calculating measures of biological interaction[J]. European Journal of Epidemiology, 2005, 20(7): 575 - 579.
[ 22 ]刘福东,梁宏光.胆囊结石患者绝经前后脂联素水平影响雌激素分泌及对胆结石形成的相关性分析[J].中国妇幼保健,2014,29(18):2862 - 2863.Liu FD, Liang HG. Correlation analysis of adiponectin level on estrogen secretion and gallstone formation in patients with gallstone before and after menopause[J]. Maternal & Child Health Care of China, 2014, 29(18): 2862 - 2863.
[ 23 ]Pagliarulo M, Fornari F, Fraquelli M, et al. Gallstone disease and related risk factors in a large cohort of diabetic patients[J]. Digestive and Liver Disease: Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2004, 36(2): 130 - 134.
[ 24 ]Liu CM, Hsu CT, Li CY, et al. A population - based cohort study of symptomatic gallstone disease in diabetic patients[J]. World Journal of Gastroenterology, 2012, 18(14): 1652 - 1659.
[ 25 ]Qiao QH, Zhu WH, Yu YX, et al. Nonalcoholic fatty liver was associated with asymptomatic gallstones in a Chinese population[J]. Medicine, 2017, 96(38): e7853.
[ 26 ]Smith BW, Adams LA. Nonalcoholic fatty liver disease and diabetes mellitus: pathogenesis and treatment[J]. Nature Reviews Endocrinology, 2011, 7(8): 456 - 465.
[ 27 ]Smith BW, Adams LA. Non - alcoholic fatty liver disease[J]. Critical Reviews in Clinical Laboratory Sciences, 2011, 48(3): 97 - 113.
[ 28 ]梁家铭,商秀丽,李进,等.肥胖症与糖尿病对胆石症发病的交互作用[J].肝胆胰外科杂志,2021,33(1):15 - 19.Liang JM, Shang XL, Li J, et al. The synergistic effect of obesity and diabetes on gallstone disease[J]. Journal of Hepatopancreatobiliary Surgery, 2021, 33(1): 15 - 19.
[ 29 ]徐小华,吴锦丹,谢晓竞,等.2型糖尿病伴非酒精性脂肪肝患者胰岛功能及血脂分析[J].实用医学杂志,2008,24(22):3890 - 3891.Xu XH, Wu JD, Xie XJ, et al. Islet function and lipid analysis in type 2 diabetes with nonalcoholic fatty liver disease[J]. The Journal of Practical Medicine, 2008, 24(22): 3890 - 3891.

备注/Memo

备注/Memo:
基金项目:国家重点研发计划课题(2017YFC0907301);贵州省科技计划项目(黔科合平台人才[2018]5403)
作者简介:刘云涛(1995—),男,硕士在读,研究方向:疾病预防与控制
通信作者:曾奇兵,E-mail: zengqibing@gmc.edu.cn
更新日期/Last Update: 2022-07-28