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Article(id=1241067204544885692, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202409542, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1727539200000, receivedDateStr=2024-09-29, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773823079477, onlineDateStr=2026-03-18, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773823079477, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773823079477, creator=13701087609, updateTime=1773823079477, updator=13701087609, issue=Issue{id=1241067197318091153, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773823077754, creator=13701087609, updateTime=1773823268053, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067995544482681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067995544482682, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=826, endPage=830, ext={EN=ArticleExt(id=1241067206860141560, articleId=1241067204544885692, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between anxiety disorders and the risk of non-alcoholic fatty liver disease in Caucasians, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the association between anxiety disorders and the risk of developing non-alcoholic fatty liver disease (NAFLD) in Caucasians.

Methods

This study was a prospective cohort study based on the UK Biobank database.Individuals who were not Caucasian, had missing racial information, had liver disease at baseline, had alcohol/drug use disorders or missing relevant diagnosis dates, or developed NAFLD within two years of follow-up were excluded, resulting in a total of 465 621 participants for analysis. The baseline survey conducted from 2006 to 2010 served as the starting point for follow-up, with NAFLD incidence, loss to follow-up, death, or end of follow-up as the endpoints. A multivariable Cox proportional hazards regression model was used to explore the association between anxiety disorders and the risk of developing NAFLD.

Results

The participants accumulated 6 058 222 person-years of follow-up, with a median follow-up time of 13.50 years. There were 5 184 cases of NAFLD, with an incidence density of 8.56 cases per 10 000 person-years. After adjusting for covariates, the risk of developing NAFLD in individuals with anxiety disorders was increased by 0.75 times compared to those without anxiety disorders (HR=1.75, 95%CI: 1.32-2.32).

Conclusion

Anxiety disorders are associated with an increased risk of developing NAFLD in Caucasians, highlighting the need for enhanced clinical monitoring and prevention of NAFLD in patients with anxiety disorders.

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目的

探究白种人焦虑症与非酒精性脂肪性肝病（non-alcoholic fatty liver disease, NAFLD）发生风险之间的关联。

方法

本研究为前瞻性队列研究，基于英国生物银行数据库，剔除非白种人或种族信息缺失、基线时患有肝病、酒精/药物使用障碍或者相关诊断日期缺失、随访2年内发生NAFLD的个体后，共有465 621名研究对象纳入分析。以2006—2010年基线调查为随访起点，以NAFLD发生、失访、死亡或随访结束为随访终点。使用多因素Cox比例风险回归模型探索焦虑症与NAFLD发生风险之间的关联。

结果

研究对象累积随访6 058 222人年，中位随访时间为13.50年，NAFLD病例有5 184例，发病密度为8.56例/万人年。调整协变量后，与无焦虑症患者相比，焦虑症患者的NAFLD发生风险增加了0.75倍（HR=1.75，95%CI：1.32 ~ 2.32）。

结论

在白种人中，焦虑症会增加NAFLD发生风险，因此应加强对焦虑症患者在NAFLD方面的临床监测与预防。

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龙璐，E-mail: ；
郑玥，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=f918r5BXnuPSxdaoDNSo+w==, magXml=dlwtEiZXKUHIVw+OzFDxUg==, pdfUrl=null, pdf=p4vQMqfhQObOnAS9mdiD/w==, pdfFileSize=4000450, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=Wc+votEVbhcI4cVku+B2Yg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=y4iGHQ1SjuE8s+B/abfgyA==, mapNumber=null, authorCompany=null, fund=null, authors=

龙璐与郑玥为共同通信作者

周晓瑞（1997—），女，硕士在读，研究方向：流行病学

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周晓瑞（1997—），女，硕士在读，研究方向：流行病学

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周晓瑞（1997—），女，硕士在读，研究方向：流行病学

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pmid=null, pmcid=null, year=2021, volume=397, issue=10290, pageStart=2212, pageEnd=2224, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Powell EE, Wong VWS, Rinella M, journalName=Lancet, refType=null, unstructuredReference=Powell EE, Wong VWS, Rinella M. Non-alcoholic fatty liver disease[J]. Lancet, 2021, 397(10290): 2212-2224., articleTitle=Non-alcoholic fatty liver disease, refAbstract=null), Reference(id=1241067221993190004, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2021, volume=6, issue=7, pageStart=578, pageEnd=588, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Targher G, Tilg H, Byrne CD, journalName=Lancet Gastroenterol Hepatol, refType=null, unstructuredReference=Targher G, Tilg H, Byrne CD. Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach[J]. Lancet Gastroenterol Hepatol, 2021, 6(7): 578-588., articleTitle=Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach, refAbstract=null), Reference(id=1241067222148379258, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2024, volume=53, issue=5, pageStart=766, pageEnd=771, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=秦亚君, 彭海洋, 刘彦, journalName=重庆医学, refType=null, unstructuredReference=秦亚君，彭海洋，刘彦，等.非酒精性脂肪性肝病临床管理的研究进展[J].重庆医学[J]，2024，53（5）：766-771., articleTitle=非酒精性脂肪性肝病临床管理的研究进展, refAbstract=null), Reference(id=1241067222244848256, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2024, volume=53, issue=5, pageStart=766, pageEnd=771, url=null, language=null, rfNumber=[3], rfOrder=3, authorNames=Qin YJ, Peng HY, Liu Y, journalName=Chongqing Medicine, refType=null, unstructuredReference=Qin YJ, Peng HY, Liu Y, et al. Advances in clinical management of non-alcoholic fatty liver disease[J]. Chongqing Medicine, 2024, 53(5): 766-771.(In Chinese), articleTitle=Advances in clinical management of non-alcoholic fatty liver disease, refAbstract=null), Reference(id=1241067222316151431, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2022, volume=75, issue=5, pageStart=1218, pageEnd=1234, url=null, language=null, rfNumber=[4], rfOrder=4, authorNames=Zhang JL, Du BB, Zhang DH, journalName=Hepatology, refType=null, unstructuredReference=Zhang JL, Du BB, Zhang DH, et al. OTUB1 alleviates NASH through inhibition of the TRAF6-ASK1 signaling pathways[J].Hepatology, 2022, 75(5): 1218-1234., articleTitle=OTUB1 alleviates NASH through inhibition of the TRAF6-ASK1 signaling pathways, refAbstract=null), Reference(id=1241067222408426125, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2022, volume=328, issue=24, pageStart=2431, pageEnd=2445, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=Szuhany KL, Simon NM, journalName=JAMA : the Journal of the American Medical Association, refType=null, unstructuredReference=Szuhany KL, Simon NM. Anxiety disorders: a review[J]. JAMA : the Journal of the American Medical Association, 2022, 328(24): 2431-2445., articleTitle=Anxiety disorders: a review, refAbstract=null), Reference(id=1241067222513283731, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2024, volume=403, issue=10440, pageStart=2133, pageEnd=2161, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=GBD 2021 Diseases and Injuries Collaborators, journalName=Lancet, refType=null, unstructuredReference=GBD 2021 Diseases and Injuries Collaborators. Global incidence. Prevalence, years lived with disability(YLDs), disability-adjusted life-years(DALYs),and healthy Life expectancy(HALE)for 371 diseases and injuries in 204 countries and territories and 811 subnational locations,1990-2021: a systematic analysis for the global burden of disease study 2021[J]. Lancet, 2024, 403(10440): 2133-2161., articleTitle=Global incidence. Prevalence, years lived with disability(YLDs), disability-adjusted life-years(DALYs),and healthy Life expectancy(HALE)for 371 diseases and injuries in 204 countries and territories and 811 subnational locations,1990-2021: a systematic analysis for the global burden of disease study 2021, refAbstract=null), Reference(id=1241067224019038879, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2022, volume=162, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=7, authorNames=Mersha AG, Tollosa DN, Bagade T, journalName=Journal of Psychosomatic Research, refType=null, unstructuredReference=Mersha AG, Tollosa DN, Bagade T, et al. A bidirectional relationship between diabetes mellitus and anxiety: A systematic review and meta-analysis[J]. Journal of Psychosomatic Research,2022, 162: 110991., articleTitle=A bidirectional relationship between diabetes mellitus and anxiety: A systematic review and meta-analysis, refAbstract=null), Reference(id=1241067224119702181, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2021, volume=131, issue=null, pageStart=96, pageEnd=119, url=null, language=null, rfNumber=[8], rfOrder=8, authorNames=Lim LF, Solmi M, Cortese S, journalName=Neuroscience & Biobehavioral Reviews, refType=null, unstructuredReference=Lim LF, Solmi M, Cortese S. Association between anxiety and hypertension in adults: A systematic review and meta-analysis[J]. Neuroscience & Biobehavioral Reviews, 2021, 131: 96-119., articleTitle=Association between anxiety and hypertension in adults: A systematic review and meta-analysis, refAbstract=null), Reference(id=1241067224207782570, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2020, volume=10, issue=1, pageStart=2261, pageEnd=null, url=null, language=null, rfNumber=[9], rfOrder=9, authorNames=Li RC, Zhang LY, Luo H, journalName=Scientific Reports, refType=null, unstructuredReference=Li RC, Zhang LY, Luo H, et al. Subclinical hypothyroidism and anxiety May contribute to metabolic syndrome in Sichuan of China: a hospital-based population study[J]. Scientific Reports,2020, 10(1): 2261., articleTitle=Subclinical hypothyroidism and anxiety May contribute to metabolic syndrome in Sichuan of China: a hospital-based population study, refAbstract=null), Reference(id=1241067224291668655, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2022, volume=315, issue=null, pageStart=291, pageEnd=296, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=Wu M, Zhu YQ, Lv J, journalName=Journal of Affective Disorders, refType=null, unstructuredReference=Wu M, Zhu YQ, Lv J, et al.Association of anxiety with cardiovascular disease in a Chinese cohort of 0.5 million adults[J].Journal of Affective Disorders, 2022, 315: 291-296., articleTitle=Association of anxiety with cardiovascular disease in a Chinese cohort of 0.5 million adults, refAbstract=null), Reference(id=1241067224400720566, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2013, volume=33, issue=7, pageStart=1062, pageEnd=1070, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=Youssef NA, Abdelmalek MF, Binks M, journalName=Liver International, refType=null, unstructuredReference=Youssef NA, Abdelmalek MF, Binks M, et al. Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease[J]. Liver International, 2013, 33(7):1062-1070., articleTitle=Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease, refAbstract=null), Reference(id=1241067224480412346, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2006, volume=68, issue=4, pageStart=563, pageEnd=569, url=null, language=null, rfNumber=[12], rfOrder=12, authorNames=Elwing JE, Lustman PJ, Wang HL, journalName=Psychosomatic Medicine, refType=null, unstructuredReference=Elwing JE, Lustman PJ, Wang HL, et al. Depression, anxiety, and nonalcoholic steatohepatitis[J]. Psychosomatic Medicine, 2006, 68(4):563-569., articleTitle=Depression, anxiety, and nonalcoholic steatohepatitis, refAbstract=null), Reference(id=1241067224572687040, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=13, authorNames=余荻, journalName=null, refType=null, unstructuredReference=余荻.焦虑与非酒精性脂肪性肝病的相关性分析[D].昆明：昆明医科大学，2022., articleTitle=焦虑与非酒精性脂肪性肝病的相关性分析, refAbstract=null), Reference(id=1241067224660767433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=14, authorNames=Yu D, journalName=null, refType=null, unstructuredReference=Yu D. The analysis of correlation between non-alcoholic fatty liver disease and anxiety disorder[D]. Kunming: Kunming Medical University, 2022.(In Chinese), articleTitle=The analysis of correlation between non-alcoholic fatty liver disease and anxiety disorder, refAbstract=null), Reference(id=1241067224757236430, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2023, volume=66, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[14], rfOrder=15, authorNames=Nakada S, Ho FK, Celis-Morales C, journalName=European Psychiatry :the Journal of the Association of European Psychiatrists, refType=null, unstructuredReference=Nakada S, Ho FK, Celis-Morales C, et al. Individual and joint associations of anxiety disorder and depression with cardiovascular disease: A UK Biobank prospective cohort study[J]. European Psychiatry :the Journal of the Association of European Psychiatrists, 2023, 66(1): e54., articleTitle=Individual and joint associations of anxiety disorder and depression with cardiovascular disease: A UK Biobank prospective cohort study, refAbstract=null), Reference(id=1241067224849511120, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2023, volume=23, issue=1, pageStart=1282, pageEnd=null, url=null, language=null, rfNumber=[15], rfOrder=16, authorNames=Huang HK, Liu ZN, Xie JR, journalName=BMC Public Health, refType=null, unstructuredReference=Huang HK, Liu ZN, Xie JR, et al. Association between night shift work and NAFLD: a prospective analysis of 281,280 UK Biobank participants[J]. BMC Public Health, 2023, 23(1): 1282., articleTitle=Association between night shift work and NAFLD: a prospective analysis of 281,280 UK Biobank participants, refAbstract=null), Reference(id=1241067224992117466, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2022, volume=76, issue=5, pageStart=1021, pageEnd=1029, url=null, language=null, rfNumber=[16], rfOrder=17, authorNames=Petermann-Rocha F, Gray SR, Forrest E, journalName=Journal of Hepatology, refType=null, unstructuredReference=Petermann-Rocha F, Gray SR, Forrest E, et al. Associations of muscle mass and grip strength with severe NAFLD: A prospective study of 333,295 UK Biobank participants[J]. Journal of Hepatology, 2022, 76(5): 1021-1029., articleTitle=Associations of muscle mass and grip strength with severe NAFLD: A prospective study of 333,295 UK Biobank participants, refAbstract=null), Reference(id=1241067225096975070, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2021, volume=74, issue=1, pageStart=474, pageEnd=482, url=null, language=null, rfNumber=[17], rfOrder=18, authorNames=Hagström H, Adams LA, Allen AM, journalName=Hepatology, refType=null, unstructuredReference=Hagström H, Adams LA, Allen AM, et al. Administrative coding in electronic health care Record-Based research of NAFLD: an expert panel consensus statement[J]. Hepatology, 2021, 74(1): 474-482., articleTitle=Administrative coding in electronic health care Record-Based research of NAFLD: an expert panel consensus statement, refAbstract=null), Reference(id=1241067225197638373, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2024, volume=35, issue=9, pageStart=1573, pageEnd=1584, url=null, language=null, rfNumber=[18], rfOrder=19, authorNames=Mahmud M, Muscatello DJ, Rahman MB, journalName=Osteoporosis International, refType=null, unstructuredReference=Mahmud M, Muscatello DJ, Rahman MB, et al. Association between socioeconomic deprivation and bone health status in the UK biobank cohort participants[J]. Osteoporosis International, 2024, 35(9): 1573-1584., articleTitle=Association between socioeconomic deprivation and bone health status in the UK biobank cohort participants, refAbstract=null), Reference(id=1241067225327661805, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2021, volume=186, issue=6, pageStart=389, pageEnd=398, url=null, language=null, rfNumber=[19], rfOrder=20, authorNames=Skelton M, Rayner C, Purves KL, journalName=American Journal of Medical Genetics. Part B,Neuropsychiatric Genetics: the Official Publication of the International Society of Psychiatric Genetics, refType=null, unstructuredReference=Skelton M, Rayner C, Purves KL, et al. Self-reported medication use as an alternate phenotyping method for anxiety and depression in the UK Biobank[J]. American Journal of Medical Genetics. Part B,Neuropsychiatric Genetics: the Official Publication of the International Society of Psychiatric Genetics, 2021, 186(6): 389-398., articleTitle=Self-reported medication use as an alternate phenotyping method for anxiety and depression in the UK Biobank, refAbstract=null), Reference(id=1241067225440908017, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2024, volume=165, issue=1, pageStart=213, pageEnd=223, url=null, language=null, rfNumber=[20], rfOrder=21, authorNames=Li MM, Cao SM, Dimou N, journalName=Chest, refType=null, unstructuredReference=Li MM, Cao SM, Dimou N, et al. Association of metabolic syndrome with risk of lung cancer: a Population-Based prospective cohort study[J]. Chest, 2024, 165(1): 213-223., articleTitle=Association of metabolic syndrome with risk of lung cancer: a Population-Based prospective cohort study, refAbstract=null), Reference(id=1241067225549959926, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2020, volume=18, issue=1, pageStart=261, pageEnd=null, url=null, language=null, rfNumber=[21], rfOrder=22, authorNames=Soto-Angona ó, Anmella G, Valdés-Florido MJ, journalName=BMC Medicine, refType=null, unstructuredReference=Soto-Angona ó, Anmella G, Valdés-Florido MJ, et al.Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches[J]. BMC Medicine, 2020, 18(1): 261., articleTitle=Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches, refAbstract=null), Reference(id=1241067225667400445, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2016, volume=19, issue=6, pageStart=753, pageEnd=756, url=null, language=null, rfNumber=[22], rfOrder=23, authorNames=陶叶婷, 范建高, journalName=实用肝脏病杂志, refType=null, unstructuredReference=陶叶婷， 范建高.心理应激与非酒精性脂肪性肝病[J].实用肝脏病杂志，2016，19（6）：753-756., articleTitle=心理应激与非酒精性脂肪性肝病, refAbstract=null), Reference(id=1241067225768063746, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2016, volume=19, issue=6, pageStart=753, pageEnd=756, url=null, language=null, rfNumber=[22], rfOrder=24, authorNames=Tao YT, Fan JG, journalName=Journal of Clinical Hepatology, refType=null, unstructuredReference=Tao YT, Fan JG. Psychological stress in nonalcoholic fatty liver diseases[J].Journal of Clinical Hepatology, 2016, 19(6): 753-756.(In Chinese), articleTitle=Psychological stress in nonalcoholic fatty liver diseases, refAbstract=null), Reference(id=1241067225893892873, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2020, volume=36, issue=11, pageStart=2589, pageEnd=2592, url=null, language=null, rfNumber=[23], rfOrder=25, authorNames=余荻, 杨旭瑶, 赵锦涵, journalName=临床肝胆病杂志, refType=null, unstructuredReference=余荻，杨旭瑶，赵锦涵，等.焦虑与非酒精性脂肪性肝病的关系[J].临床肝胆病杂志，2020，36（11）：2589-2592., articleTitle=焦虑与非酒精性脂肪性肝病的关系, refAbstract=null), Reference(id=1241067225981973260, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2020, volume=36, issue=11, pageStart=2589, pageEnd=2592, url=null, language=null, rfNumber=[23], rfOrder=26, authorNames=Yu D, Yang XY, Zhao JH, journalName=Journal of Clinical Hepatology, refType=null, unstructuredReference=Yu D, Yang XY, Zhao JH, et al. Association between anxiety and nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2020, 36(11): 2589-2592.(In Chinese), articleTitle=Association between anxiety and nonalcoholic fatty liver disease, refAbstract=null), Reference(id=1241067226091025168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, doi=null, pmid=null, pmcid=null, year=2017, volume=186, issue=9, pageStart=1026, pageEnd=1034, url=null, language=null, rfNumber=[24], rfOrder=27, authorNames=Fry A, Littlejohns TJ, Sudlow C, journalName=American Journal of Epidemiology, refType=null, unstructuredReference=Fry A, Littlejohns TJ, Sudlow C, et al. Comparison of sociodemographic and Health-Related characteristics of UK biobank participants with those of the general population[J].American Journal of Epidemiology, 2017, 186(9): 1026-1034., articleTitle=Comparison of sociodemographic and Health-Related characteristics of UK biobank participants with those of the general population, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241067208936321200, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, xref=1., ext=[AuthorCompanyExt(id=1241067208944709809, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, companyId=1241067208936321200, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Epidemiology and Health Statistics, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1241067208948904115, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, companyId=1241067208936321200, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系，四川 成都 610041)]), AuthorCompany(id=1241067209053761728, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, xref=2., ext=[AuthorCompanyExt(id=1241067209062150336, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, companyId=1241067209053761728, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.自贡市第一人民医院)]), AuthorCompany(id=1241067210563711188, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, xref=3., ext=[AuthorCompanyExt(id=1241067210572099797, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, companyId=1241067210563711188, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.四川大学华西公共卫生学院/华西第四医院消化内科，四川 成都 610041)])], figs=[ArticleFig(id=1241067217085854213, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=EN, label=Figure 1, caption=Cumulative incidence of NAFLD in patients with and without anxiety disorders, figureFileSmall=2tFgvmNhTjOuMuq6HZtSnw==, figureFileBig=Wc+votEVbhcI4cVku+B2Yg==, tableContent=null), ArticleFig(id=1241067217203294736, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=CN, label=图1, caption=焦虑症与非焦虑症患者中NAFLD累积发病率, figureFileSmall=2tFgvmNhTjOuMuq6HZtSnw==, figureFileBig=Wc+votEVbhcI4cVku+B2Yg==, tableContent=null), ArticleFig(id=1241067217475924515, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=EN, label=Table 1, caption=

Baseline characteristics of the study participants

, figureFileSmall=null, figureFileBig=null, tableContent=
变量名称合计焦虑症患者非焦虑症患者W/χ2值P值
人数465 6211 714463 907
年龄（岁）58.0 (50.0, 63.0)58.0 (51.0, 63.0)58.0 (50.0, 63.0)396 228 0710.809
性别19.178<0.001
女性255 067 (54.8)1 029 (60.0)254 038 (54.8)
男性210 554 (45.2)685 (40.0)209 869 (45.2)
汤森剥夺指数-2.3 (-3.7, 0.2)-1.3 (-3.3, 1.8)-2.3 (-3.7, 0.2)333 550 622<0.001
受教育程度167.148<0.001
无任何学历79 074 (17.0)472 (27.5)78 602 (16.9)
其他学历238 000 (51.1)867 (50.6)237 133 (51.1)
大专或本科学位148 547 (31.9)375 (21.9)148 172 (31.9)
地区5.8880.053
英格兰411 261 (88.3)1 531 (89.3)409 730 (88.3)
苏格兰34 453 (7.4)102 (6.0)34 351 (7.4)
威尔士19 907 (4.3)81 (4.7)19 826 (4.3)
吸烟状况53.606<0.001
从不253 624 (54.5)880 (51.3)252 744 (54.5)
曾经164 810 (35.4)569 (33.2)164 241 (35.4)
现在47 187 (10.1)265 (15.5)46 922 (10.1)
饮酒频率419.136<0.001
每天或几乎每天97 412 (20.9)255 (14.9)97 157 (20.9)
每周3～4次111 235 (23.9)250 (14.6)110 985 (23.9)
每周一次或两次123 187 (26.5)401 (23.4)122 786 (26.5)
每月1 ～3次52 214 (11.2)232 (13.5)51 982 (11.2)
仅在特殊场合50 707 (10.9)294 (17.2)50 413 (10.9)
从不30 866 (6.6)282 (16.5)30 584 (6.6)
体力活动水平75.447<0.001
低69 801 (15.0)342 (20.0)69 459 (15.0)
中153 267 (32.9)483 (28.2)152 784 (32.9)
高151 943 (32.6)471 (27.5)151 472 (32.7)
缺失90 610 (19.5)418 (24.4)90 192 (19.4)
BMI（kg/m2）109.415<0.001
<18.52 231 (0.5)14 (0.8)2 217 (0.5)
18.5～24.9149 682 (32.1)411 (24.0)149 271 (32.2)
25.0～29.9200 461 (43.1)704 (41.1)199 757 (43.1)
≥30.0113 247 (24.3)585 (34.1)112 662 (24.3)
加工肉类摄入频率18.7370.002
从不40 213 (8.6)183 (10.7)40 030 (8.6)
每周少于一次141 675 (30.4)537 (31.3)141 138 (30.4)
每周一次137 998 (29.6)454 (26.5)137 544 (29.6)
每周2～4次127 578 (27.4)458 (26.7)127 120 (27.4)
每周5～6次14 556 (3.1)68 (4.0)14 488 (3.1)
每天一次或多次3 601 (0.8)14 (0.8)3 587 (0.8)
油性鱼类摄入频率68.223<0.001
从不49 606 (10.7)255 (14.9)49 351 (10.6)
每周少于一次154 183 (33.1)517 (30.2)153 666 (33.1)
每周一次178 972 (38.4)575 (33.5)178 397 (38.5)
每周2～4次78 875 (16.9)341 (19.9)78 534 (16.9)
每周5～6次3 080 (0.7)16 (0.9)3 064 (0.7)
每天一次或多次905 (0.2)10 (0.6)895 (0.2)
抗焦虑药使用922.505<0.001
否460 607 (98.9)1 566 (91.4)459 041 (99.0)
是5 014 (1.1)148 (8.6)4 866 (1.0)
高血糖78.630<0.001
否427 867 (91.9)1 475 (86.1)426 392 (91.9)
是37 754 (8.1)239 (13.9)37 515 (8.1)
高血压3.8810.049
否124 983 (26.8)424 (24.7)124 559 (26.8)
是340 638 (73.2)1 290 (75.3)339 348 (73.2)
高甘油三酯血症31.263<0.001
否290 123 (62.3)956 (55.8)289 167 (62.3)
是175 498 (37.7)758 (44.2)174 740 (37.7)
低高密度脂蛋白胆固醇55.327<0.001
否387 132 (83.1)1 310 (76.4)385 822 (83.2)
是78 489 (16.9)404 (23.6)78 085 (16.8)
), ArticleFig(id=1241067217614336559, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=CN, label=表1, caption=

研究对象的基线特征

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变量名称合计焦虑症患者非焦虑症患者W/χ2值P值
人数465 6211 714463 907
年龄（岁）58.0 (50.0, 63.0)58.0 (51.0, 63.0)58.0 (50.0, 63.0)396 228 0710.809
性别19.178<0.001
女性255 067 (54.8)1 029 (60.0)254 038 (54.8)
男性210 554 (45.2)685 (40.0)209 869 (45.2)
汤森剥夺指数-2.3 (-3.7, 0.2)-1.3 (-3.3, 1.8)-2.3 (-3.7, 0.2)333 550 622<0.001
受教育程度167.148<0.001
无任何学历79 074 (17.0)472 (27.5)78 602 (16.9)
其他学历238 000 (51.1)867 (50.6)237 133 (51.1)
大专或本科学位148 547 (31.9)375 (21.9)148 172 (31.9)
地区5.8880.053
英格兰411 261 (88.3)1 531 (89.3)409 730 (88.3)
苏格兰34 453 (7.4)102 (6.0)34 351 (7.4)
威尔士19 907 (4.3)81 (4.7)19 826 (4.3)
吸烟状况53.606<0.001
从不253 624 (54.5)880 (51.3)252 744 (54.5)
曾经164 810 (35.4)569 (33.2)164 241 (35.4)
现在47 187 (10.1)265 (15.5)46 922 (10.1)
饮酒频率419.136<0.001
每天或几乎每天97 412 (20.9)255 (14.9)97 157 (20.9)
每周3～4次111 235 (23.9)250 (14.6)110 985 (23.9)
每周一次或两次123 187 (26.5)401 (23.4)122 786 (26.5)
每月1 ～3次52 214 (11.2)232 (13.5)51 982 (11.2)
仅在特殊场合50 707 (10.9)294 (17.2)50 413 (10.9)
从不30 866 (6.6)282 (16.5)30 584 (6.6)
体力活动水平75.447<0.001
低69 801 (15.0)342 (20.0)69 459 (15.0)
中153 267 (32.9)483 (28.2)152 784 (32.9)
高151 943 (32.6)471 (27.5)151 472 (32.7)
缺失90 610 (19.5)418 (24.4)90 192 (19.4)
BMI（kg/m2）109.415<0.001
<18.52 231 (0.5)14 (0.8)2 217 (0.5)
18.5～24.9149 682 (32.1)411 (24.0)149 271 (32.2)
25.0～29.9200 461 (43.1)704 (41.1)199 757 (43.1)
≥30.0113 247 (24.3)585 (34.1)112 662 (24.3)
加工肉类摄入频率18.7370.002
从不40 213 (8.6)183 (10.7)40 030 (8.6)
每周少于一次141 675 (30.4)537 (31.3)141 138 (30.4)
每周一次137 998 (29.6)454 (26.5)137 544 (29.6)
每周2～4次127 578 (27.4)458 (26.7)127 120 (27.4)
每周5～6次14 556 (3.1)68 (4.0)14 488 (3.1)
每天一次或多次3 601 (0.8)14 (0.8)3 587 (0.8)
油性鱼类摄入频率68.223<0.001
从不49 606 (10.7)255 (14.9)49 351 (10.6)
每周少于一次154 183 (33.1)517 (30.2)153 666 (33.1)
每周一次178 972 (38.4)575 (33.5)178 397 (38.5)
每周2～4次78 875 (16.9)341 (19.9)78 534 (16.9)
每周5～6次3 080 (0.7)16 (0.9)3 064 (0.7)
每天一次或多次905 (0.2)10 (0.6)895 (0.2)
抗焦虑药使用922.505<0.001
否460 607 (98.9)1 566 (91.4)459 041 (99.0)
是5 014 (1.1)148 (8.6)4 866 (1.0)
高血糖78.630<0.001
否427 867 (91.9)1 475 (86.1)426 392 (91.9)
是37 754 (8.1)239 (13.9)37 515 (8.1)
高血压3.8810.049
否124 983 (26.8)424 (24.7)124 559 (26.8)
是340 638 (73.2)1 290 (75.3)339 348 (73.2)
高甘油三酯血症31.263<0.001
否290 123 (62.3)956 (55.8)289 167 (62.3)
是175 498 (37.7)758 (44.2)174 740 (37.7)
低高密度脂蛋白胆固醇55.327<0.001
否387 132 (83.1)1 310 (76.4)385 822 (83.2)
是78 489 (16.9)404 (23.6)78 085 (16.8)
), ArticleFig(id=1241067217714999861, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=EN, label=Table 2, caption=

Cox proportional hazards regression analysis of anxiety disorders and risk of new-onset NAFLD

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模型HR（95%CI）P值
模型12.71（2.05～3.60）<0.001
模型22.28（1.72～3.03）<0.001
模型31.75（1.32～2.32）<0.001
), ArticleFig(id=1241067217803080254, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=CN, label=表2, caption=

白种人焦虑症与NAFLD发生风险的Cox比例风险回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
模型HR（95%CI）P值
模型12.71（2.05～3.60）<0.001
模型22.28（1.72～3.03）<0.001
模型31.75（1.32～2.32）<0.001
), ArticleFig(id=1241067217916326470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=EN, label=Table 3, caption=

Subgroup analysis of anxiety disorders and risk of new-onset NAFLD

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变量名称新发病例数HR（95%CI）P交互
性别0.340
女性2 7741.91（1.35～2.72）
男性2 4101.50（0.93～2.42）
年龄（岁）0.242
<602 7941.92（1.36～2.72）
≥602 3901.43（0.87～2.34）
吸烟状况0.869
从不2 3161.64（1.05～2.55）
曾经/现在2 8681.85（1.28～2.67）
饮酒频率0.464
非过量饮酒2 1411.96（1.38～2.79）
过量饮酒3 0431.51（0.94～2.43）
BMI（kg/m2）0.502
<254920.99（0.24～3.99）
≥254 6921.84（1.38～2.46）
高血糖0.802
否3 9681.67（1.18～2.35）
是1 2161.84（1.12～3.03）
高血压0.262
否8642.31（1.27～4.20）
是4 3201.62（1.18～2.24）
), ArticleFig(id=1241067218033766990, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=CN, label=表3, caption=

白种人焦虑症与NAFLD发生风险的亚组分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量名称新发病例数HR（95%CI）P交互
性别0.340
女性2 7741.91（1.35～2.72）
男性2 4101.50（0.93～2.42）
年龄（岁）0.242
<602 7941.92（1.36～2.72）
≥602 3901.43（0.87～2.34）
吸烟状况0.869
从不2 3161.64（1.05～2.55）
曾经/现在2 8681.85（1.28～2.67）
饮酒频率0.464
非过量饮酒2 1411.96（1.38～2.79）
过量饮酒3 0431.51（0.94～2.43）
BMI（kg/m2）0.502
<254920.99（0.24～3.99）
≥254 6921.84（1.38～2.46）
高血糖0.802
否3 9681.67（1.18～2.35）
是1 2161.84（1.12～3.03）
高血压0.262
否8642.31（1.27～4.20）
是4 3201.62（1.18～2.24）
), ArticleFig(id=1241067221414376022, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=EN, label=Table 4, caption=

Sensitivity analysis of anxiety disorders and risk of new-onset NAFLD

, figureFileSmall=null, figureFileBig=null, tableContent=
敏感性分析HR（95%CI）P值
敏感性分析11.99（1.50～2.64）<0.001
敏感性分析21.90（1.41～2.55）<0.001
敏感性分析31.73（1.30～2.31）<0.001
敏感性分析41.72（1.30～2.29）<0.001
), ArticleFig(id=1241067221565370975, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067204544885692, language=CN, label=表4, caption=

白种人焦虑症与NAFLD发生风险的Cox比例风险回归分析（敏感性分析）

, figureFileSmall=null, figureFileBig=null, tableContent=
敏感性分析HR（95%CI）P值
敏感性分析11.99（1.50～2.64）<0.001
敏感性分析21.90（1.41～2.55）<0.001
敏感性分析31.73（1.30～2.31）<0.001
敏感性分析41.72（1.30～2.29）<0.001
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白种人焦虑症与非酒精性脂肪性肝病发生风险的关联
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周晓瑞 1 , 李朗 2 , 郑玥 3 , 廖娟 3 , 龙璐 1
现代预防医学 | 流行病与统计方法 2025,52(5): 826-830
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现代预防医学 | 流行病与统计方法 2025, 52(5): 826-830
白种人焦虑症与非酒精性脂肪性肝病发生风险的关联
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周晓瑞1, 李朗2, 郑玥3 , 廖娟3, 龙璐1
作者信息
  • 1.四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系，四川 成都 610041
  • 2.自贡市第一人民医院
  • 3.四川大学华西公共卫生学院/华西第四医院消化内科，四川 成都 610041

    • 周晓瑞（1997—），女，硕士在读，研究方向：流行病学

通讯作者:

龙璐，E-mail: ；
郑玥，E-mail:
Association between anxiety disorders and the risk of non-alcoholic fatty liver disease in Caucasians
Xiao-rui ZHOU1, Lang LI2, Yue ZHENG3 , Juan LIAO3, Lu LONG1
Affiliations
  • Department of Epidemiology and Health Statistics, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2025-03-10 doi: 10.20043/j.cnki.MPM.202409542
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摘要
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目的

探究白种人焦虑症与非酒精性脂肪性肝病（non-alcoholic fatty liver disease, NAFLD）发生风险之间的关联。

方法

本研究为前瞻性队列研究，基于英国生物银行数据库，剔除非白种人或种族信息缺失、基线时患有肝病、酒精/药物使用障碍或者相关诊断日期缺失、随访2年内发生NAFLD的个体后，共有465 621名研究对象纳入分析。以2006—2010年基线调查为随访起点，以NAFLD发生、失访、死亡或随访结束为随访终点。使用多因素Cox比例风险回归模型探索焦虑症与NAFLD发生风险之间的关联。

结果

研究对象累积随访6 058 222人年，中位随访时间为13.50年，NAFLD病例有5 184例，发病密度为8.56例/万人年。调整协变量后，与无焦虑症患者相比，焦虑症患者的NAFLD发生风险增加了0.75倍（HR=1.75，95%CI：1.32 ~ 2.32）。

结论

在白种人中，焦虑症会增加NAFLD发生风险，因此应加强对焦虑症患者在NAFLD方面的临床监测与预防。

焦虑症  /  非酒精性脂肪性肝病  /  生存分析  /  队列研究
Objective

To investigate the association between anxiety disorders and the risk of developing non-alcoholic fatty liver disease (NAFLD) in Caucasians.

Methods

This study was a prospective cohort study based on the UK Biobank database.Individuals who were not Caucasian, had missing racial information, had liver disease at baseline, had alcohol/drug use disorders or missing relevant diagnosis dates, or developed NAFLD within two years of follow-up were excluded, resulting in a total of 465 621 participants for analysis. The baseline survey conducted from 2006 to 2010 served as the starting point for follow-up, with NAFLD incidence, loss to follow-up, death, or end of follow-up as the endpoints. A multivariable Cox proportional hazards regression model was used to explore the association between anxiety disorders and the risk of developing NAFLD.

Results

The participants accumulated 6 058 222 person-years of follow-up, with a median follow-up time of 13.50 years. There were 5 184 cases of NAFLD, with an incidence density of 8.56 cases per 10 000 person-years. After adjusting for covariates, the risk of developing NAFLD in individuals with anxiety disorders was increased by 0.75 times compared to those without anxiety disorders (HR=1.75, 95%CI: 1.32-2.32).

Conclusion

Anxiety disorders are associated with an increased risk of developing NAFLD in Caucasians, highlighting the need for enhanced clinical monitoring and prevention of NAFLD in patients with anxiety disorders.

Anxiety disorders  /  Non-alcoholic fatty liver disease  /  Survival analysis  /  Cohort study
周晓瑞, 李朗, 郑玥, 廖娟, 龙璐. 白种人焦虑症与非酒精性脂肪性肝病发生风险的关联. 现代预防医学, 2025 , 52 (5) : 826 -830 . DOI: 10.20043/j.cnki.MPM.202409542
Xiao-rui ZHOU, Lang LI, Yue ZHENG, Juan LIAO, Lu LONG. Association between anxiety disorders and the risk of non-alcoholic fatty liver disease in Caucasians[J]. Modern Preventive Medicine, 2025 , 52 (5) : 826 -830 . DOI: 10.20043/j.cnki.MPM.202409542
正文
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非酒精性脂肪性肝病（non-alcoholic fatty liver disease, NAFLD）是全球最常见的慢性肝病，全球患病率约为25%[1-2]，除外过量饮酒和其他明确的损肝因素所致的肝细胞内脂肪沉积，包括从单纯的肝脂肪变性（non-alcoholic fatty liver，NAFL）到非酒精性脂肪性肝炎（non-alcoholic steatohepatitis，NASH）[3]，NAFLD被认为是代谢综合征的肝脏表现[4]。焦虑症是全球最常见的心理健康问题之一，其主要症状为忧虑、社交和表现恐惧、意外和/或诱发的惊恐发作、预期焦虑以及回避行为[5]，据最近一次全球疾病负担研究统计，2021年焦虑症的全球年龄标化患病率约为4 421.9/10万[6]。目前已有流行病学研究表明，焦虑症与代谢综合征以及糖尿病、高血压、心血管疾病等普遍伴有NAFLD的疾病之间存在显著关联[7-10]。
随着生物-心理-社会医学模式的不断发展，且作为代谢综合征的肝脏表现，目前已有部分研究关注焦虑症与NAFLD的关联，但既往研究样本量小，多为横断面研究和病例对照研究，且研究结果不一致[11-13]。因此，本研究将基于英国生物银行数据库（UK Biobank，UKB），探索焦虑症与NAFLD发生风险之间的关联，为NAFLD的预防及干预提供参考。
1　材料与方法
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1.1　研究对象
本研究使用的数据来源为UKB，项目申请号为84980。UKB是一项英国的多中心前瞻性队列研究，于2006—2010年进行基线调查，在英国的英格兰、苏格兰和威尔士的22个评估中心招募了50多万名年龄在40～69岁的参与者（https://www.ukbiobank.ac.uk/）。参与者填写了电子触摸屏问卷及专业护士指导的问卷，问卷包括社会人口学信息、生活方式、环境因素和疾病史等信息，并且参与了身体测量、临床生化及基因检测。UKB健康相关结局的随访主要是基于英国国家医疗服务体系国家健康数据库的常规更新，包括初级保健记录、医院住院信息、死亡登记及肿瘤登记等。UKB已获得英国西北多中心研究伦理委员会的伦理批准，所有参与者在数据收集之前均已签署知情同意书。
本研究排除了非白种人或种族信息缺失（n=29 798）（由于该部分人群数量有限，并为了尽量减少人口结构偏倚）、基线时患有肝病或酒精/药物使用障碍（n=6 719）、相关确切诊断日期缺失（n=1）以及随访2年内发生NAFLD的参与者（n=262）之后，最终纳入了465 621名研究对象。以2006—2010年基线调查为随访起点，随访至NAFLD发生、失访、死亡或随访结束（英格兰为2022年10月31日，苏格兰为2021年7月31日，威尔士为2018年2月28日），以先发生事件为准。
1.2　研究方法
1.2.1　暴露测量
基线焦虑症患病情况来源于英国医院住院信息，由英国英格兰、苏格兰和威尔士的相关合作机构提供。使用《国际疾病分类》第十次修订本（International Classification of Diseases，ICD-10）代码定义焦虑症，具体代码为F40-F43（F40 恐怖性焦虑障碍、F41 其他焦虑障碍、F42 强迫性障碍、F43 严重应激反应及适应障碍）[14]。当参与者的焦虑症诊断日期早于其参加UKB基线调查的日期，则认为其在基线患有焦虑症。
1.2.2　结局测量
NAFLD发生的定义是因NAFLD或NASH而住院或死亡，通过与英国医院住院信息和死亡登记的数据链接来确定[15-16]。NAFLD（包括NASH）在最新的专家小组共识声明中被定义为ICD-10 K76.0（脂肪肝，不可归类在他处者）和K75.8（其他特指的炎性肝脏疾病）[17]。
1.2.3　协变量测量
本研究纳入的协变量包括年龄、性别、身体质量指数（body mass index，BMI）、汤森剥夺指数、受教育程度、饮酒频率、吸烟状况、油性鱼类摄入频率、加工肉类摄入频率、体力活动水平、抗焦虑药使用、高血糖、高血压、高甘油三酯血症、低高密度脂蛋白胆固醇。
BMI为体重（kg）除以身高的二次方（m2）。汤森剥夺指数用于表示社会经济状况，得分越高表示社会经济剥夺程度越高[18]。体力活动水平通过国际体力活动问卷评估，分为低、中、高三组。抗焦虑药物包括佐匹克隆、地西泮、替马西泮等45种药物[19]。高血糖定义为糖化血红蛋白≥42.0 mmol/mol或自我报告医生诊断为糖尿病；高血压定义为收缩压≥130 mm Hg和/或舒张压≥85 mm Hg或自我报告医生诊断为高血压；高甘油三酯血症定义为甘油三酯≥1.7 mmol/L；低高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）定义为女性HDL-C<1.3 mmol/L，男性HDL-C<1.0 mmol/L[20]。
1.3　统计分析
对于连续型变量和分类变量，分别用性别特异性中位数和众数填补缺失值。由于体力活动水平的缺失率较高，因此使用缺失指标法进行填补。连续型变量用中位数和四分位数间距表示，分类变量用频数和构成比表示，分别采用Wilcoxon秩和检验（非正态分布）和χ2检验比较组间差异。采用Kaplan-Meier法计算不同组别终点事件的累积发生率，并采用Log-rank检验比较各组终点事件累积发生率的差异。构建多因素Cox比例风险回归模型分析焦虑症与NAFLD发生风险之间的关联，使用风险比（hazards ratio，HR）衡量效应大小，并计算95%置信区间（95% confidence interval，95%CI）。通过Schoenfeld残差法检验比例风险假设。此外，在回归模型中分别纳入性别、年龄、吸烟状况、饮酒频率、BMI、高血糖、高血压与焦虑症的相乘交互项分析两者之间是否存在交互作用，并根据以上特征进行亚组分析。为检验研究结果的稳健性，本研究进行了四项敏感性分析：（1）排除在基线调查后发生焦虑症的个体；（2）排除在随访5年内发生NAFLD的个体；（3）排除仅在死亡登记记录里被确定为发生NAFLD的个体；（4）采用多重插补法对缺失值进行填补。
本研究中数据分析主要采用R软件（4.1.2版本）进行，检验水准α=0.05。
2　结果
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2.1　研究对象的基线特征
在纳入分析的465 621名研究对象中，基线调查时研究对象的中位年龄为58.00岁，中位随访时间为13.50年，累积随访6 058 222人年。研究对象中有1 714名为焦虑症患者，焦虑症患者与非焦虑症患者在性别、汤森剥夺指数、受教育程度、吸烟状况、饮酒频率、体力活动水平、BMI、加工肉类摄入频率、油性鱼类摄入频率、抗焦虑药使用、高血糖、高血压、高甘油三酯血症、低HDL-C的差异均有统计学意义（均P<0.05）。见表1。
2.2　焦虑症患者与非焦虑症患者NAFLD的累积发病率比较
本研究中共新发NAFLD病例5 184例，总人群发病密度为8.56例/万人年，其中焦虑症患者中新发NAFLD病例有49例，累积发病率为3.33%；非焦虑症患者中新发NAFLD病例有5 135例，累积发病率为1.30%。焦虑症患者NAFLD的累积发病率高于非焦虑症患者（P<0.001）。见图1。
2.3　白种人焦虑症与NAFLD发生风险的关联
以基线焦虑症患病情况（是，否）为自变量。模型1为未调整任何协变量的Cox模型，焦虑症患者的NAFLD发生风险是非焦虑症患者的2.71倍。模型2为调整了年龄、性别和BMI后的Cox模型，结果显示，与非焦虑症患者相比，焦虑症患者的NAFLD发生风险增加了1.28倍。模型3的协变量在模型2的基础上进一步调整了汤森剥夺指数、受教育程度、饮酒频率、吸烟状况、油性鱼类摄入频率、加工肉类摄入频率、体力活动水平、抗焦虑药使用、高血糖、高血压、高甘油三酯血症、低HDL-C，结果显示，与非焦虑症患者相比，焦虑症患者的NAFLD发生风险增加了0.75倍（均P<0.05）。见表2。
2.4　亚组分析和敏感性分析结果
整协变量后，性别、年龄、吸烟状况、饮酒频率、BMI、高血糖、高血压与焦虑症之间对NAFLD的发生无交互作用（均P交互>0.05）。见表3。
排除了在基线调查后发生焦虑症的个体后，焦虑症患者的NAFLD发生风险增加了0.99倍；排除了在随访5年内发生NAFLD的个体后，焦虑症患者的NAFLD发生风险增加了0.90倍；排除了仅在死亡登记记录里被确定为发生NAFLD的个体后，焦虑症患者的NAFLD发生风险增加了0.73倍；采用多重插补法对协变量的缺失值进行填补后，焦虑症患者的NAFLD发生风险增加了0.72倍。各敏感性分析结果均显示焦虑症与NAFLD发生风险有统计学关联，进一步支持两者关联的稳健性较好（均P<0.05）。见表4。
3　讨论
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本研究利用大型前瞻性队列数据分析了白种人焦虑症与NAFLD发生风险间的关联，结果提示，焦虑症会增加NAFLD的发生风险。Elwing JE等人[12]对在华盛顿大学治疗的36名NASH患者及其36名匹配对照者进行了一项病例对照研究，结果表明，NASH患者的广泛性焦虑障碍终生患病率更高，广泛性焦虑障碍与更严重的肝活检组织学特征相关，且对纤维化程度有独立影响。而Youssef NA等人[11]对杜克大学NAFLD临床数据库中登记的567例活检证实的NAFLD患者进行了一项横断面研究，结果显示在NAFLD患者中，焦虑类别与肝细胞气球样变程度较轻相关。余荻等人[13]对762名在昆明医科大学第二附属体检中心的体检者进行的横断面研究则发现焦虑症不是NAFLD的影响因素。研究结果的不一致与研究设计、样本量大小不相同等因素有关，有待进一步验证。
焦虑症与NAFLD关联的确切机制尚不明确，但肥胖、肠道菌群、慢性炎症、氧化应激状态等因素可能参与其中[21-23]。焦虑会激活交感神经系统和下丘脑-垂体-肾上腺轴，长期激活可导致大量儿茶酚胺释放，促进脂肪分解并导致肝内脂肪堆积。焦虑还会诱发全身慢性炎症，亦可促进外周脂肪分解，此外，焦虑可导致不健康的生活习惯，如久坐、高热量饮食、吸烟饮酒或药物使用，进而引发内脏肥胖，肥胖可导致胰岛素抵抗并且加重焦虑和炎症程度，为焦虑诱导的外周脂肪分解提供大量原料，进而导致肝脂肪变性及细胞损伤。焦虑引发的氧化应激状态可损害肠道屏障，导致肠道菌群失衡和脂多糖入血，诱导肝脏炎症，进一步加剧NAFLD的发展。
本研究存在一些局限性，首先，本研究虽控制了许多协变量，仍有可能存在未测量的潜在混杂因素，并且部分基线协变量信息是通过研究对象的自我报告收集的，存在回忆偏倚。其次，本研究采用英国医院住院信息和死亡登记中的ICD-10编码定义NAFLD，而不是通过包括肝脏影像学或肝活检组织学在内的黄金诊断标准。此外，NAFLD症状常不明显，部分患者可能未就医，故在此大规模人群研究中，可能存在未确诊的NAFLD病例，进而低估其实际发病率。最后，UKB招募的参与者在社会经济特征和生活方式方面并不代表英国的一般人群，因此风险估计可以推广，但患病率和发病率等统计信息不应推广[24]。
综上所述，本研究结果显示，在白种人中焦虑症会增加NAFLD发生的风险，应长期监测焦虑症患者的NAFLD相关指标，以便及早发现并干预潜在的肝脏损害。
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参考文献 引证文献
排序方式：
[1]
Powell EE, Wong VWS, Rinella M. Non-alcoholic fatty liver disease[J]. Lancet, 2021, 397(10290): 2212-2224.
[2]
Targher G, Tilg H, Byrne CD. Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach[J]. Lancet Gastroenterol Hepatol, 2021, 6(7): 578-588.
[3]
秦亚君，彭海洋，刘彦，等.非酒精性脂肪性肝病临床管理的研究进展[J].重庆医学[J]，2024，53（5）：766-771.
Qin YJ, Peng HY, Liu Y, et al. Advances in clinical management of non-alcoholic fatty liver disease[J]. Chongqing Medicine, 2024, 53(5): 766-771.(In Chinese)
[4]
Zhang JL, Du BB, Zhang DH, et al. OTUB1 alleviates NASH through inhibition of the TRAF6-ASK1 signaling pathways[J].Hepatology, 2022, 75(5): 1218-1234.
[5]
Szuhany KL, Simon NM. Anxiety disorders: a review[J]. JAMA : the Journal of the American Medical Association, 2022, 328(24): 2431-2445.
[6]
GBD 2021 Diseases and Injuries Collaborators. Global incidence. Prevalence, years lived with disability(YLDs), disability-adjusted life-years(DALYs),and healthy Life expectancy(HALE)for 371 diseases and injuries in 204 countries and territories and 811 subnational locations,1990-2021: a systematic analysis for the global burden of disease study 2021[J]. Lancet, 2024, 403(10440): 2133-2161.
[7]
Mersha AG, Tollosa DN, Bagade T, et al. A bidirectional relationship between diabetes mellitus and anxiety: A systematic review and meta-analysis[J]. Journal of Psychosomatic Research,2022, 162: 110991.
[8]
Lim LF, Solmi M, Cortese S. Association between anxiety and hypertension in adults: A systematic review and meta-analysis[J]. Neuroscience & Biobehavioral Reviews, 2021, 131: 96-119.
[9]
Li RC, Zhang LY, Luo H, et al. Subclinical hypothyroidism and anxiety May contribute to metabolic syndrome in Sichuan of China: a hospital-based population study[J]. Scientific Reports,2020, 10(1): 2261.
[10]
Wu M, Zhu YQ, Lv J, et al.Association of anxiety with cardiovascular disease in a Chinese cohort of 0.5 million adults[J].Journal of Affective Disorders, 2022, 315: 291-296.
[11]
Youssef NA, Abdelmalek MF, Binks M, et al. Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease[J]. Liver International, 2013, 33(7):1062-1070.
[12]
Elwing JE, Lustman PJ, Wang HL, et al. Depression, anxiety, and nonalcoholic steatohepatitis[J]. Psychosomatic Medicine, 2006, 68(4):563-569.
[13]
余荻.焦虑与非酒精性脂肪性肝病的相关性分析[D].昆明：昆明医科大学，2022.
Yu D. The analysis of correlation between non-alcoholic fatty liver disease and anxiety disorder[D]. Kunming: Kunming Medical University, 2022.(In Chinese)
[14]
Nakada S, Ho FK, Celis-Morales C, et al. Individual and joint associations of anxiety disorder and depression with cardiovascular disease: A UK Biobank prospective cohort study[J]. European Psychiatry :the Journal of the Association of European Psychiatrists, 2023, 66(1): e54.
[15]
Huang HK, Liu ZN, Xie JR, et al. Association between night shift work and NAFLD: a prospective analysis of 281,280 UK Biobank participants[J]. BMC Public Health, 2023, 23(1): 1282.
[16]
Petermann-Rocha F, Gray SR, Forrest E, et al. Associations of muscle mass and grip strength with severe NAFLD: A prospective study of 333,295 UK Biobank participants[J]. Journal of Hepatology, 2022, 76(5): 1021-1029.
[17]
Hagström H, Adams LA, Allen AM, et al. Administrative coding in electronic health care Record-Based research of NAFLD: an expert panel consensus statement[J]. Hepatology, 2021, 74(1): 474-482.
[18]
Mahmud M, Muscatello DJ, Rahman MB, et al. Association between socioeconomic deprivation and bone health status in the UK biobank cohort participants[J]. Osteoporosis International, 2024, 35(9): 1573-1584.
[19]
Skelton M, Rayner C, Purves KL, et al. Self-reported medication use as an alternate phenotyping method for anxiety and depression in the UK Biobank[J]. American Journal of Medical Genetics. Part B,Neuropsychiatric Genetics: the Official Publication of the International Society of Psychiatric Genetics, 2021, 186(6): 389-398.
[20]
Li MM, Cao SM, Dimou N, et al. Association of metabolic syndrome with risk of lung cancer: a Population-Based prospective cohort study[J]. Chest, 2024, 165(1): 213-223.
[21]
Soto-Angona ó, Anmella G, Valdés-Florido MJ, et al.Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches[J]. BMC Medicine, 2020, 18(1): 261.
[22]
陶叶婷， 范建高.心理应激与非酒精性脂肪性肝病[J].实用肝脏病杂志，2016，19（6）：753-756.
Tao YT, Fan JG. Psychological stress in nonalcoholic fatty liver diseases[J].Journal of Clinical Hepatology, 2016, 19(6): 753-756.(In Chinese)
[23]
余荻，杨旭瑶，赵锦涵，等.焦虑与非酒精性脂肪性肝病的关系[J].临床肝胆病杂志，2020，36（11）：2589-2592.
Yu D, Yang XY, Zhao JH, et al. Association between anxiety and nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2020, 36(11): 2589-2592.(In Chinese)
[24]
Fry A, Littlejohns TJ, Sudlow C, et al. Comparison of sociodemographic and Health-Related characteristics of UK biobank participants with those of the general population[J].American Journal of Epidemiology, 2017, 186(9): 1026-1034.
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doi: 10.20043/j.cnki.MPM.202409542
  • 接收时间：2024-09-29
  • 首发时间：2026-03-18
  • 出版时间：2025-03-10
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  • 收稿日期：2024-09-29
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    1.四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系，四川 成都 610041
    2.自贡市第一人民医院
    3.四川大学华西公共卫生学院/华西第四医院消化内科，四川 成都 610041

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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