摘要目的:分析健康体检人群瘦型非酒精性脂肪性肝病人体成分和影响因素。方法:本研究为横断面研究，选取2020年1月至2021年12月江苏省人民医院健康管理中心体检人群中肝脏瞬时弹性成像和人体成分检测结果完整可靠、体重指数（BMI）<24 kg/m 2且符合纳入标准的体检者共1 342例，收集研究对象的人体成分分析、血生化指标及肝脏检查等结果进行分析。符合正态分布的计量资料采用独立样本 t检验，不符合则用秩和检验，计数资料采用 χ2检验进行统计学检验，采用二元logistic回归对健康体检人群瘦型非酒精性脂肪性肝病人体成分的影响因素进行分析。 结果:研究对象中，非酒精性脂肪性肝病检出率为13.3%，男性检出率为23.3%（125/537），高于女性的6.6%（53/805）。男女性瘦型非酒精性脂肪性肝病人群空腹血糖（5.15、5.08 mmol/L）、糖化血红蛋白（5.5%、5.6%）、甘油三酯（1.70、1.64 mmol/L）、低密度脂蛋白胆固醇（3.37、3.27 mmol/L）、丙氨酸转氨酶（27.0、21.9 U/L）、天冬氨酸转氨酶（24.1、24.0 U/L）、γ谷氨酰转肽酶（31.4、21.1 U/L）、尿酸（391、296 μmol/L）、体脂率（23.9%、33.7%）、腰臀比（0.90、0.89）以及内脏脂肪面积（70.3、97.0 cm 2）均高于非脂肪肝人群（均 P<0.05），而高密度脂蛋白胆固醇（1.25、1.32 mmol/L）低于非脂肪肝人群。BMI、糖化血红蛋白、甘油三酯、尿酸、腰臀比是男性瘦型非酒精性脂肪性肝病的危险因素，BMI、糖化血红蛋白、甘油三酯、尿酸、体脂率是女性瘦型非酒精性脂肪性肝病的危险因素（均 P<0.05）。 结论:BMI、糖化血红蛋白、甘油三酯、尿酸、体脂率、腰臀比与瘦型非酒精性脂肪性肝病的发生相关。

abstractsObjective:To analyze the body composition and influencing factors of lean non-alcoholic fatty liver disease in population receiving health examination.Methods:This is a cross-sectional study. Between January 2020 and December 2021, 1 342 individuals who had complete and reliable results of liver transient elastography and body composition testing, with a body mass index (BMI)<24 kg/m 2 and who met the inclusion criteria, were selected from the physical examination population at the Health Management Center of Jiangsu Provincial People′s Hospital. The results of body composition analysis, blood biochemical indexes and liver examination were collected from the subjects for analysis. Method of inter-group comparison: quantitative data that conform to normal distribution were tested using independent sample t-test, while non-conforming data were tested using rank sum test; count data were tested using chi-square test. The binary logistic regression analysis was used to analyze the influencing factors of body composition in lean non-alcoholic fatty liver disease in health examinees. Results:The detection rate of non-alcoholic fatty liver disease was 13.3% in all participants, and it was significantly higher in men than that in women (23.3% (125/537) vs 6.6% (53/805)). The fasting blood glucose (5.15, 5.08 mmol/L), hemoglobin A1c (HbA 1c)(5.5%, 5.6%), triglyceride (TG)(1.70, 1.64 mmol/L), low density lipoprotein cholesterol (LDL-C)(3.37, 3.27 mmol/L), alanine aminotransferase (ALT)(27.0, 21.9 U/L), aspartate aminotransferase (AST)(24.1, 24.0 U/L), gamma-glutamyltransferase (31.4, 21.1 U/L), uric acid (UA)(391, 296 μmol/L), body fat percentage (23.9%, 33.7%), waist-to-hip ratio(0.90, 0.89) and visceral fat area (70.3, 97.0 cm 2) in men and women with lean nonalcoholic fatty liver disease were all higher than those in the population without fatty liver, while the density lipoprotein cholesterol (1.25, 1.32 mmol/L) was lower. Logistic regression analysis showed that BMI, HbA 1c, TG, UA and waist-to-hip ratio were risk factors for lean nonalcoholic fatty liver disease in men, while BMI, HbA 1c, TG, UA and body fat percentage were risk factors for lean nonalcoholic fatty liver disease in women (all P<0.05). Conclusion:BMI, HbA 1c, TG, UA, body fat percentage and waist-to-hip ratio are associated with the development of lean nonalcoholic fatty liver disease.