在非瘦人群中非酒精性脂肪性肝病的临床特征
Min-Ran Li1, Jin-Zhong Li2, Jie-Ying Li2
1Division of Infectious Disease, The First Affiliated Hospital of Jinan University, Guangzhou, China, muziran@126.com.
Obesity facts
|May 26, 2023
概括
患有非酒精性脂肪性肝病 (NAFLD) 的肥胖和超重个体表现出明显的临床和组织学特征. 结合AST,BMI,ALT和CHOL的新指数比传统标志物更好地预测纤维化.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 代谢障碍 代谢障碍 代谢障碍
- 临床研究 临床研究
背景情况:
- 非酒精性脂肪性肝病 (NAFLD) 的患病率在非瘦身人群中正在上升.
- 肥胖是已知的晚期肝病风险因素,包括NAFLD患者肝硬化和肝细胞癌 (HCC).
- 超重和肥胖个体之间的NAFLD临床和组织学特征的差异尚未得到充分理解.
研究的目的:
- 调查超重患者和肥胖非瘦患者中NAFLD的临床和组织学差异.
- 在这个人群中确定中度至重度纤维化的预测因素.
- 评估一种新的肝纤维化预测指数.
主要方法:
- 分析了184名患有NAFLD和肝活检数据的非瘦身患者队列.
- 患者被分为超重 (BMI 23<28 kg/m2) 和肥胖 (BMI ≥28 kg/m2) 的两组.
- 临床,组织学和生物化学数据进行了比较;逻辑回归分析了纤维化预测因素.
主要成果:
- 肥胖患者表现出较低的马-氨基甲酶,较高的血小板,葡萄糖和前血红蛋白时间,以及更频繁的中度至重度炎症.
- 在肥胖组 (19.33%) 与超重组 (40.00%) 相比,中度至重度纤维化发生的频率明显较低.
- 亚斯巴酸胺酶 (AST),BMI,亚氨酸胺酶 (ALT) 和胆固醇 (CHOL) 独立地预测了纤维化. 综合指数 (AST,BMI,ALT,CHOL) 显示出比FIB-4 (AUC=0.77) 和APRI (AUC=0.79) 的更高的预测准确度 (AUC=0.87).
结论:
- NAFLD的临床和组织学特征在超重和肥胖的非瘦身个体之间有所不同.
- 结合AST,BMI,ALT和CHOL的新型预测指数显示,与既有标志物相比,在非瘦体NAFLD患者中识别中度至重度纤维化的准确性提高了.
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