从NAFLD到MASLD:当代谢并发症重要时
Shan Hong1, Lei Sun2, Yiwei Hao3
1Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Annals of hepatology
|December 22, 2023
概括
新的代谢相关脂肪性肝病 (MASLD) 定义更好地识别显著的肝纤维化,而不是非酒精性脂肪性肝病 (NAFLD). 三个或更多的心脏代谢风险因素表明纤维化风险较高.
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
- 肝脏疾病的分期.
背景情况:
- 非酒精性脂肪性肝病 (NAFLD) 正被重新定义为与代谢相关的脂肪性肝病 (MASLD).
- 修改后的诊断标准伴随着拟议的命名规范变更.
- 这种重新分类对识别显著肝纤维化的影响需要调查.
研究的目的:
- 评估拟议的MASLD定义在识别显著肝纤维化的有效性.
- 为了比较MASLD和Cryptogenic-SLD分类之间显著纤维化的患病率和危险因素.
主要方法:
- 对428名在2009年至2022年期间被诊断出具有活检证明的肝肥胖症的患者进行了回顾性分析.
- 根据既定和拟议的标准,将患者分为NAFLD,MASLD和Cryptogenic-SLD亚组.
- 临床病理特征的比较和对MASLD队列中显著纤维化风险因素的分析.
主要成果:
- 与Cryptogenic-SLD相比,MASLD患者表现出较大的组织学疾病严重程度.
- 显著的纤维化患病率随着心脏代谢风险因素 (CMRF) 的数量增加而增加,达到3个或更多的42.5% (p=0.001).
- 在MASLD中显著纤维化的独立风险因素包括较低的白蛋白 (ALB),较低的血小板计数 (PLT) 和更多的代谢并发症.
结论:
- 拟议的MASLD命名法和标准比以前的NAFLD定义更有效地识别显著的肝纤维化.
- 患有三种或以上心脏代谢风险因素的患者代表患有肝纤维化风险高的高风险群体.
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