摘要

【摘要】
目的 研究心理压力与代谢相关脂肪性肝病（Metabolic Dysfunction-associated Fatty Liver Disease, MAFLD）的关联，并探讨甘油三酯与锻炼强度的中介作用。

方法 分析开封市中心医院2022年6月至2024年6月体检入组的2935名成年人，依据腹部超声将人群分为MAFLD组及非MAFLD组，采用压力知觉量表（10-item Perceived Stress Scale-10, PSS-10）评估心理压力水平。比较两组临床资料；采用Spearman相关分析压力与MAFLD的相关性；采用非条件Logistic回归分析压力对MAFLD的独立影响；采用基于Bootstrap法的并行中介模型，分析甘油三酯与运动锻炼强度的中介效应。

结果 MAFLD组的PSS-10评分显著高于非MAFLD组（14.41±4.89 vs. 10.91±4.20, P<0.001）。心理压力与MAFLD患病呈正相关（r=0.339, P<0.001）。多因素Logistic回归分析显示，调整混杂因素后，心理压力是脂肪肝发生的独立危险因素（OR=1.158, 95% CI: 1.125~1.193, P<0.001）。中介分析显示，心理压力对MAFLD的影响部分通过升高甘油三酯和降低锻炼强度两条路径实现。

结论 心理压力是MAFLD的独立危险因素，其影响部分通过升高甘油三酯和较低的锻炼强度介导。在MAFLD的临床防治中，应重视心理压力评估并进行身心综合干预。

关键词：【关键词】代谢相关脂肪性肝病；知觉压力；Logistic回归；中介效应；横断面研究

ABSTRACT

【Abstract】
Objective To study the association between stress and metabolic dysfunction-associated fatty liver disease (MAFLD), and explore the mediating roles of triglyceride and exercise intensity. 【

Methods】 A total of 2935 adults who underwent physical examination at Kaifeng Central Hospital from June 2022 to June 2024 were retrospectively analyzed. Participants were divided into MAFLD and non-MAFLD groups based on abdominal ultrasound. Psychological stress was assessed using the 10-item Perceived Stress Scale-10 (PSS-10). Clinical data were compared between the two groups. Spearman correlation analysis was used to examine the relationship between stress and MAFLD. Unconditional logistic regression was applied to analyze the independent effect of stress on MAFLD. A parallel mediation model based on the Bootstrap method was employed to analyze the mediating effects of triglyceride and exercise intensity. 【

Results】 The PSS-10 score was significantly higher in the MAFLD group than in the non-MAFLD group (14.41±4.89 vs. 10.91±4.20, P<0.001). Stress was positively correlated with MAFLD (r=0.339, P<0.001). Multivariate logistic regression analysis showed that stress remained an independent risk factor for MAFLD after adjusting for confounding factors (OR=1.158, 95% CI: 1.125–1.193, P<0.001). Mediation analysis indicated that the impact of stress on MAFLD was partially mediated through two pathways: elevated triglyceride levels and reduced exercise intensity. 【

Conclusion  】 Stress is an independent risk factor for MAFLD, and its effect is partially mediated by increased triglyceride levels and decreased exercise intensity. In the clinical prevention and management of MAFLD, attention should be paid to stress assessment and integrated psychosomatic intervention.

Key words: 【Keywords】 Metabolic dysfunction-associated fatty liver disease; Perceived stress; Logistic regression; Mediating effect; Cross-sectional study