脂肪肝盛行率相關因素的探討：某醫學中心健檢資料

Risk Factors Investigation of Fatty Liver in Patients Receiving Health Checkups: A Medical Center Base Study

許多疾病與季節變化有密切的相關，但季節變化與脂肪肝的相關性則未有相關的報告，本研究的目的在探討季節變化與脂肪肝的關係。本研究選擇了2006年12月至2007年11月一年中，溫度較低的三個月（2006年12月、2007年01月、2007年02月）當作冬季，溫度較高的三個月（2007年07月、2007年08月、2007年09月）當作夏季，以南部某醫學中心接受健康檢查的個案為研究對像，收集的資料包含人口學資料、飲酒及抽菸習慣、過去疾病史、實驗室檢查與腹部超音波檢查結果進行分析，扣除資料不完整者，得有效研究樣本2,026人，男性1,197人(59.1%)，女性829人(40.9%)，平均年齡50.0±12.6歲，整體受檢者的脂肪肝盛行率為51.8% (1,049人)，其中在夏季受檢者脂肪肝的盛行率為53.7%，冬天為48.5%；經單變項分析得季節、年齡、性別、喝酒習慣、有糖尿病病史、有高血壓病史、有心臟病病史、血壓異常、腰圍異常、體重過重、肥胖、B型肝炎帶原、飯前血糖偏高、血脂肪偏高、肝功能異常為脂肪肝的危險因子；經多變項邏輯式回歸分析，控制與脂肪肝相關的多項危險因子後，季節變化仍為脂肪肝的獨立危險因子(p<0.01)；結果顯示在夏季罹患脂肪肝的危險性是在冬季的1.5倍，建議以後脂肪肝的研究，可納入季節改變為危險因子。

Many illnesses are closely related to seasonal changes. However, the relationship between seasonal changes and fatty liver has not been reported. Therefore, we investigated the relationship between seasonal changes and fatty liver. This study selected three months with lower temperatures between December 2006 and November 2007 (December 2006; January 2007; and February 2007) as the winter season; three of months with higher temperatures (July 2007; August 2007; and September 2007) were designated as the summer season. The individuals undergoing health examinations in a medical centre in southern Taiwan were enrolled as subjects for this research. The patient demographics, smoking and drinking habits, medical history, laboratory findings, and abdominal ultrasound results were collected and analyzed. After excluding those with missing data, 2,026 individuals were eligible for this study. The study cohort included 1197 males (59.1%) and 829 females (40.9%), with a mean age of 50.0±12.6 years. The prevalence of fatty liver in the subjects was 51.8% (n=1,049), with a prevalence of 53.7% in the summer and 48.5% in the winter. Based on univariant analysis, the following were risk factors for fatty liver: season, age, gender, drinking habits, a history of diabetes, a history of hypertension, a history of cardiac disease, an abnormal blood pressure, an abnormal waist circumference, overweight, obesity, hepatitis B carrier, higher fasting plasma glucose levels, higher lipids levels, and abnormal liver function. Using multivariate logistic regression analysis, and after controlling for the multiple risk factors of fatty liver, seasonal changes were still an independent risk factor for fatty liver (p＜0.01), and the odds ratio was 1.5. Thus, fatty liver has a higher prevalence in the summer compared to the winter. We therefore suggest that studies focusing on the components of fatty liver should take season into account as possible confounding effects.