在瘦肉代谢功能障碍相关的脂肪性肝病的更新
Karina Sato-Espinoza1, Perapa Chotiprasidhi2, Mariella R Huaman3
1Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55902, United States. sato.angela@mayo.edu.
World journal of hepatology
|April 5, 2024
概括
瘦个体的代谢功能障碍相关的脂肪性肝病 (MASLD) 是复杂的,受遗传学和代谢的影响. 瘦身MASLD患者面临着一个更糟糕的预后,尽管生活方式的改善,突出需要进一步的研究.
科学领域:
- 肝病学和胃肠病学 肝病学和胃肠学
- 代谢和心血管疾病
背景情况:
- 一个新的命名法定义了与代谢功能障碍相关的脂肪性肝病 (MASLD),以前称为NAFLD/MAFLD,结合了心脏代谢标准.
- 虽然在超重个体中进行了广泛的研究,但MASLD影响大约10%-15%的瘦人群,病因不明.
研究的目的:
- 系统地审查有关MASLD在瘦个体中的诊断,发病,特征和预后的文献.
- 解释新的命名标准对瘦肉MASLD患者的影响.
主要方法:
- 在PubMed和谷歌学者 (2012-2023) 的综合文献搜索中,寻找精简的NAFLD,MAFLD或MASLD研究.
- 包括关于瘦肉BMI的成年人 (≥18岁) 的原始文章 (世卫组织标准:≤25 kg/m2一般,≤23 kg/m2亚洲).
主要成果:
- 瘦肉性NAFLD的患病率差异很大 (3.8%-34.1%);病原发生涉及遗传,表观遗传和代谢因素.
- 常见的危险因素包括代谢综合征,高血压和2型糖尿病,患病率各不相同.
- 纤维化-4指数优于NAFLD纤维化得分;生活方式的改变改善了肥胖症和心脏代谢概况,但瘦身患者的预后比超重患者更差.
结论:
- MASLD的发病因子是多因素的 (表观遗传,遗传,代谢),结果因人群,性别和年龄而异.
- 有限的临床实践指南适用于瘦身患者.
- 为了标准化瘦脂性肝病的结果,需要使用新的MASLD命名法进行未来的研究.
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