鸡蛋摄入与非酒精性脂肪肝病患病风险的病例对照研究

陈冰冰; 李慧泉; 潘欣婷; 李扬帆; 刘文娟; 闫建慧; 徐尚华; 彭仙娥

doi:10.16462/j.cnki.zhjbkz.2020.07.005

鸡蛋摄入与非酒精性脂肪肝病患病风险的病例对照研究

doi: 10.16462/j.cnki.zhjbkz.2020.07.005

1.
350000 福州, 福建医科大学公共卫生学院流行病与卫生统计学系
2.
350000 福州, 福建省疾病预防控制中心
3.
350000 福州, 福建省儿童医院
4.
570100 海口, 海南医学院第二附属医院院感科
5.
353000 南平, 南平市第一医院

基金项目:

福建省自然科学基金资助项目 2019J01316

详细信息

通讯作者:
彭仙娥, E-mail:fmuxe@163.com

中图分类号: R181.1
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出版历程
- 收稿日期: 2019-12-15
- 修回日期: 2020-01-07
- 刊出日期: 2020-07-10

A case-control study on the association between egg consumption and risk of non-alcoholic fatty liver disease

1.
Department of Epidemiology and Statistics, College of Public Health, Fujian Medical University, Fuzhou 350000, China
2.
Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350000, China
3.
Fujian Children's Hospital, Fuzhou 350000, China
4.
Department of Hospital Infection-Control, The Second Affiliated Hospital of Hainan Medical University, Haikou 570100, China
5.
Nanping First Hospital, Nanping 353000, China

Funds:

Natural Science Foundation of Fujian Province 2019J01316

More Information

Corresponding author: PENG Xian-e, E-mail:fmuxe@163.com

摘要

摘要: 目的探讨鸡蛋摄入与非酒精性脂肪肝病（non-alcoholic fatty liver disease，NAFLD）患病风险的关系，为NAFLD的防控提供流行病学依据。方法收集2015年4月―2017年8月在南平市第一医院体检中心进行健康检查的体检者数据，以腹部彩超确诊的541名病例和按年龄性别随机抽取的541名对照进行病例对照研究。采用统一编制的结构式调查问卷及半定量食物频数问卷面对面调查研究对象的一般行为特征及膳食摄入情况。多因素非条件Logistic回归分析模型计算OR值及其95%CI，探索鸡蛋摄入与NAFLD患病风险的关系。结果与每天摄入鸡蛋相比，鸡蛋摄入频率为0患NAFLD的风险增高，其调整的OR值及其95% CI为1.86（95% CI：1.10~3.15）。敏感分析结果及亚组分析均显示从不摄入鸡蛋仍然是NAFLD的危险因素。结论从不摄入鸡蛋可能增高NAFLD的患病风险。
- 鸡蛋摄入 /
- 非酒精性脂肪肝病 /
- 病例对照研究
Abstract: Objective To explore the association between egg consumption and risk of non-alcoholic fatty liver disease(NAFLD). Methods We conducted a retrospective case-control study including 541 patients diagnosed with NAFLD and 541 controls matched by sex and age from the Affiliated Nanping First Hospital of Fujian Medical University in Nangping City. Information on dietary intake was collected using a semiquantitative food frequency questionnaire and egg consumption was calculated. Binary Logistic regression model was used to estimate OR and the 95% confidence interval (95% CI) was for the association between egg consumption and NAFLD risk. Results Compared with 7 times/week egg consumption, non-egg consumers was associated with higher risk of NAFLD, and the adjusted ORs and 95% CI 1.86 (95%CI:1.10-3.15). The sensitivity analyses and stratified analysis results showed that non-egg consumers was significantly associated with risk of developing NAFLD. Conclusions Non-egg consumption was significantly associated with higher risk of NAFLD, largely independent of other risk factors.
- Egg consumption /
- Non-alcoholic fatty liver disease /
- Case-control study

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图 1 鸡蛋摄入频率与NAFLD亚组分析

Figure 1. Stratification and interaction analysis of egg intake frequency and non-alcoholic fatty liver stratification

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表 1 病例对照的一般人口学特征[n(%)]

Table 1. General demographic characteristics of case and control[n(%)]

变量	病例组(n= 541)	对照组(n= 541)	χ²/Z值	P值^a
年龄[岁，(P₂₅, P₇₅)]	48 (39, 54)	48 (39, 54)	-0.024	0.981
性别			＜0.001	1.000
男性	369 (68.21)	369 (68.21)
女性	172 (31.79)	172 (31.79)
教育程度			3.636	0.162
文盲及小学	42 (7.76)	53 (9.80)
初中及高中	226 (41.78)	198 (36.60)
大专及以上	273 (50.46)	290 (53.60)
职业			5.786	0.055
脑力劳动者	157 (29.02)	150 (27.73)
体力劳动者	162 (29.94)	198 (36.60)
其他	222 (41.04)	193 (35.67)
收入(元/月)			1.280	0.527
< 2 000	33 (6.10)	36 (6.65)
2 000~	160 (29.57)	175 (32.35)
≥3 000	348 (64.33)	330 (61.00)
BMI (kg/m²)			214.823	< 0.001
＜18.5	3 (0.55)	19 (3.51)
18.5~	172 (31.80)	387 (71.54)
24.0~	289 (53.42)	128 (23.66)
≥28.0	77 (14.23)	7 (1.29)
吸烟			0.179	0.672
是	136 (25.14)	130 (24.03)
否	405 (74.86)	411 (75.97)
饮酒			0.018	0.894
是	162 (29.94)	160 (29.57)
否	379 (70.06)	381 (70.43)
体育锻炼(h/周)			0.019	0.891
≤3	145 (26.80)	143 (26.43)
>3	396 (73.20)	398 (73.57)
慢性病史			13.582	< 0.001
是	238 (43.99)	179 (33.09)
否	303 (56.01)	362 (66.91)
收缩压[mmHg, (P₂₅, P₇₅)]	120 (132, 114)	118 (110, 126)	-6.664	< 0.001
舒张压[mmHg, (P₂₅, P₇₅)]	82 (78, 90)	80 (74, 85)	-6.490	< 0.001
TG[mmol/L, (P₂₅, P₇₅)]	1.79 (1.29, 2.53)	1.15 (0.87, 1.55)	-13.714	< 0.001
TC[mmol/L, (P₂₅, P₇₅)]	5.15 (4.65, 5.77)	4.96 (4.51, 5.52)	-2.961	0.003
HDL-C[mmol/L, (P₂₅, P₇₅)]	1.21 (1.06, 1.37)	1.35 (1.18, 1.48)	-9.149	< 0.001
LDL-C[mmol/L, (P₂₅, P₇₅)]	3.20 (2.62, 3.74)	3.10 (2.68, 3.58)	-0.933	0.531
ALT[IU/L, (P₂₅, P₇₅)]	26 (20, 38)	19 (14, 25)	-11.78	< 0.001
SUA[μmol/L, (P₂₅, P₇₅5)]	369.30 (302.74, 429.57)	340.10 (272.30, 385.24)	-6.685	< 0.001
FPG[mmol/L, (P₂₅, P₇₅)]	5.34 (5.04, 5.85)	5.13 (4.90, 5.52)	-6.551	< 0.001
膳食因素
能量[kcal, (P₂₅, P₇₅)]^b	1 954.57 (1 631.26, 2 273.60)	1 882.49 (1 556.28, 2 210.98)	-2.911	0.004
胆固醇[mg/d, (P₂₅, P₇₅)]	350.08 (241.24, 439.65)	325.62 (232.79, 435.17)	-0.651	0.515
钠[mg/d, (P₂₅, P₇₅)]	818.39 (617.38, 1034.98)	742.27 (585.08, 992.16)	-0.700	0.484
饱和脂肪酸[g/d, (P₂₅, P₇₅)]	22.35 (17.68, 30.88)	21.87 (16.46, 29.72)	-0.753	0.452
不饱和脂肪酸[g/d, (P₂₅, P₇₅)]	59.29 (52.13, 66.03)	53.15 (46.21, 59.60)	-8.160	< 0.001
红肉[g/d, (P₂₅, P₇₅)]^b	10.23 (5.99, 25.00)	11.00 (6.27, 22.47)	-1.198	0.231
牛奶[g/d, (P₂₅, P₇₅)]^b	55.00 (7.50, 125.00)	55.00 (17.50, 197.50)	-3.103	0.002
家禽[g/d, (P₂₅, P₇₅)]^b	12.59 (6.50, 22.00)	11.00 (5.04, 22.00)	-0.416	0.677
鱼类[g/d, (P₂₅, P₇₅)]^b	25.00 (14.50, 48.73)	23.32 (13.65, 45.36)	-0.238	0.812
皮蛋[g/d, (P₂₅, P₇₅)]^b	1.50 (0.00, 3.50)	1.50 (0.00, 3.50)	-0.262	0.793
注：^a分类变量用χ²检验计算所得，连续型变量用秩和检验计算所得；^b用残差法调整能量。

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表 2 鸡蛋摄入频率与NAFLD关联的多因素logistic回归分析[OR(95% CI)]

Table 2. Multivariate logistic regression analysis of the relationship between egg intake frequency and nonalcoholic fatty liver[OR(95% CI)]

鸡蛋摄入频率(次/周)	病例/对照	模型1^a	模型2^b	模型3^c
≥7	199/225	1.00	1.00	1.00
4~	172/150	0.66(0.30~1.47)	0.55(0.22~1.38)	0.64(0.24~1.68)
1~	121/105	1.55(0.86~2.78)	1.56(0.79~3.09)	1.66(0.78~3.53)
1~3 (次/月)	38/45	2.11(1.31~3.40)	1.65(0.93~2.94)	1.63(0.86~3.07)
0	11/16	2.11(1.34~3.32)	1.86(1.10~3.15)	1.82(1.02~3.23)
注: ^a调整性别和年龄；^b在模型1基础上进一步调整：BMI、教育程度、职业、收入、吸烟、饮酒、体育锻炼、慢性病史、以及能量的摄入。^c在模型2基础上进一步调整收缩压、舒张压、TG、TC、HDL-C、LDL-C、ALT、SUA、FPG。

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表 3 鸡蛋摄入频率与NAFLD关系多因素Logistic敏感性分析[OR(95% CI)]

Table 3. Sensitivity analysis of the relationship between egg intake frequency and nonalcoholic fatty [OR(95% CI)]

调整的变量	鸡蛋摄入频率
调整的变量	≥7(次/周)	4~6(次/周)	1~3(次/周)	1~3(次/月)	0
其他营养素摄入
膳食胆固醇	1.00	0.52(0.20~1.34)	1.73(0.77~3.85)	1.67(0.94~2.98)	1.98(1.10~3.57)
饱和脂肪酸	1.00	0.55(0.22~1.39)	1.61(0.81~3.19)	1.62(0.91~2.89)	1.88(1.11~3.19)
不饱和脂肪酸	1.00	0.57(0.23~1.46)	1.83(0.90~3.71)	1.43(0.79~2.59)	1.98(1.15~3.39)
钠	1.00	0.55(0.22~1.38)	1.56(0.79~3.09)	1.65(0.93~2.94)	1.86(1.09~3.15)
胆固醇相关食物的摄入
红肉	1.00	0.55(0.22~1.38)	1.55(0.78~3.08)	1.66(0.93~2.95)	1.85(1.09~3.15)
家禽	1.00	0.55(0.22~1.38)	1.56(0.79~3.09)	1.67(0.94~2.99)	1.87(1.10~3.17)
牛奶	1.00	0.55(0.22~1.37)	1.52(0.77~3.02)	1.67(0.94~2.98)	1.83(1.08~3.11)
鱼类	1.00	0.54(0.22~1.37)	1.56(0.79~3.08)	1.65(0.93~2.94)	1.86(1.10~3.15)
皮蛋	1.00	0.55(0.22~1.38)	1.59(0.80~3.15)	1.65(0.93~2.93)	1.86(1.10~3.15)
以上五种食物	1.00	0.54(0.22~1.36)	1.55(0.78~3.09)	1.69(0.94~3.02)	1.84(1.08~3.14)
注: ^a调整性别和年龄；^b在模型1基础上进一步调整：BMI、教育程度、职业、收入、吸烟、饮酒、体育锻炼、慢性病史、以及能量的摄入。^c在模型2基础上进一步调整收缩压、舒张压、TG、TC、HDL-C、LDL-C、ALT、SUA、FPG。

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表 4 每天摄入鸡蛋与NAFLD关联的多因素Logistics回归分析模型[OR(95% CI)]

Table 4. Multivariate Logistic regression analysis model of the association between daily egg intake and nonalcoholic fatty liver disease[OR(95% CI)]

鸡蛋摄入	病例/对照	模型1^a	模型2^b	模型3^c
每天未摄入	342/316	1.00	1.00	1.00
每天摄入	199/225	0.63(0.44~0.92)	0.64(0.42~0.96)	0.63(0.40~0.98)
注: ^a调整性别和年龄；^b在模型1基础上进一步调整：BMI、教育程度、职业、收入、吸烟、饮酒、体育锻炼、慢性病史、以及能量的摄入。^c在模型2基础上进一步调整收缩压、舒张压、TG、TC、HDL-C、LDL-C、ALT、SUA、FPG。

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