代谢综合征和饮酒之间的相互作用增加了肝脏疾病的风险
Hannes Hagström1,2, Hannes Hegmar1,2, Christophe Moreno3,4
1Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden.
与酒精有关的肝病 (ALD) 和与代谢功能障碍相关的脂肪性肝病 (MASLD) 具有相似之处,但ALD具有更高的肝硬化风险. 将酒精使用与代谢因素相结合显著增加了这种风险,需要进一步研究.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
- 胃肠病学 胃肠病学
背景情况:
- 与酒精有关的肝病 (ALD) 和非酒精性脂肪性肝病 (NAFLD,现在是MASLD) 具有共同的病理生理机制和遗传因素.
- 尽管有共同的特征,但ALD具有不同的自然史,与NAFLD/MASLD相比,其肝硬化和死亡风险更高.
- 与NAFLD/MASLD相关的代谢风险因素可能与酒精消费相互作用,加剧肝病的进展.
研究的目的:
- 审查有关酒精消费和代谢风险因素对肝病进展的相互作用影响的文献.
- 要突出患有ALD和代谢风险因素的患者肝硬化风险增加.
- 确定对高风险人群中晚期纤维化查策略的进一步研究的需要.
主要方法:
- 现有文献的叙述性审查.
- 对研究的分析,研究了ALD和NAFLD/MASLD之间的共同特征.
- 检查有关酒精与代谢因素对纤维化进展的相互作用影响的证据.
主要成果:
- 当独立研究时,ALD与肝硬化和与肝脏相关的死亡风险比NAFLD/MASLD更高.
- 有证据表明,酒精消费和代谢风险因素 (肥胖,糖尿病) 对纤维化进展和肝硬化发展的相互作用影响.
- 患有高酒精摄入量和代谢风险因素的患者代表了肝硬化风险特别高的群体.
结论:
- 与酒精有关的肝病和代谢风险因素的结合产生了协同效应,显著增加了进展性肝纤维化和肝硬化风险.
- 戒酒是ALD的主要干预措施,而减肥是NAFLD/MASLD的关键.
- 需要进一步的研究来评估这种高风险组合群体中晚期肝纤维化和肝硬化查的有效性.
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