在具有代谢功能障碍相关的脂肪性肝病的炎症性肠病中进行心血管风险评估
Sandra García-Mateo1, Samuel J Martínez-Domínguez1, Carla J Gargallo-Puyuelo1
1Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain.
Medicina clinica
|February 29, 2024
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 在炎症性肠病 (IBD) 患者,特别是女性中显著增加心血管风险. 密集的LDL颗粒也与该群体的早期动脉样硬化有关.
科学领域:
- 心血管医学 心血管医学
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 炎症性肠病 (IBD) 与早期动脉样硬化的风险增加有关.
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 诊断不足,与心血管风险有关,已知与IBD相关.
- 在IBD患者中评估心血管风险需要了解像MASLD这样的并发症.
研究的目的:
- 研究MASLD对IBD患者心血管风险的影响.
- 在有或没有MASLD的IBD患者中分析高级脂蛋白概况和动脉内心介质厚度 (CIMT).
- 确定与IBD中的动脉样硬化相关的特定脂蛋白子类.
主要方法:
- 这是一项对941名IBD门诊成年患者进行的横截面队列研究.
- 包括50名患有MASLD的IBD患者和50名没有MASLD的IBD患者,根据性别和年龄进行匹配.
- 通过核磁共振光谱学评估CIMT变化 (75百分点以上) 和高级脂蛋白配置文件.
主要成果:
- 58%的患者表现出异常的CIMT.
- MASLD (OR=5.05) 和女性性别 (OR=3.32) 与CIMT变化有显著的关联.
- 密集的LDL颗粒,而不是总的LDL胆固醇,与CIMT变化有关,特别是在具有高甘油三密度的年轻患者中.
结论:
- MASLD和女性性别是IBD患者早期动脉样硬化的重要危险因素.
- 密集的LDL颗粒与IBD中的亚临床动脉样硬化有关.
- 先进的脂蛋白样本和CIMT可以作为IBD心血管风险管理的非侵入性工具.
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