在1,260名非肝炎性NAFLD患者中长期的主要不良肝脏结果
Camilla Akbari1, Maja Dodd1, Per Stål1,2
1Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
JHEP reports : innovation in hepatology
|January 31, 2024
概括
患有非酒精性脂肪性肝病 (NAFLD) 的患者面临重大不良肝病结果 (MALO) 的风险明显更高. 晚期纤维化 (F3) 极大地增加了这种风险,强调了需要更好的非侵入性预后工具.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 临床流行病学 临床流行病学
背景情况:
- 对于非酒精性脂肪肝 (NAFLD) 的长期预后研究是有限的.
- 在一个大型的NAFLD队列中,调查主要不良肝脏结果 (MALO) 的风险至关重要.
研究的目的:
- 评估诊断为NAFLD的患者中MALO的长期风险.
- 评估纤维化阶段与MALO风险之间的关联.
- 为了比较肝活检和非侵入性标记物的预后能力.
主要方法:
- 一项队列研究涉及1,260名没有肝硬化的NAFLD患者,在1974-2020年间诊断出.
- 通过过渡性弹性素,活检或FIB-4得分来确定纤维化阶段,并直到2020年进行随访.
- 与12,529个一般人口控制和通过国家登记册进行的MALO检测相匹配.
主要成果:
- 与对照组相比,NAFLD患者的MALO发病率明显高 (风险增加6.6倍).
- MALO风险与纤维化阶段有很强的相关性,35%的F3患者在20年内患有MALO.
- 肝脏活检和FIB-4评分显示,MALO的预后值相似.
结论:
- 在NAFLD的自然史中,在晚期纤维化 (F3) 中,肝硬化进展率很高,导致肝硬化.
- 非侵入性纤维化评估 (例如,FIB-4) 提供了与肝脏活检可比的预后信息.
- 进一步开发NAFLD非侵入性风险分层系统是有必要的.
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