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与代谢功能障碍相关的脂肪性肝病和/或酒精相关的肝癌风险:全国性研究
Byungyoon Yun1,2,3, Heejoo Park4, Sang Hoon Ahn5,6,7
1Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
The American journal of gastroenterology
|June 27, 2024
概括
肝细胞癌 (HCC) 的风险随着代谢功能障碍相关的脂肪性肝病 (MASLD) 和酒精摄入增加. 结合MASLD和酒精 (MetALD) 或与酒精相关的肝病 (ALD) 显著增加HCC风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 最近的进展为代谢功能障碍相关的脂肪性肝病 (MASLD) 引入了新的术语.
- 了解MASLD和酒精消费之间的相互作用对于评估肝细胞癌 (HCC) 风险至关重要.
研究的目的:
- 评估MASLD,不同程度的酒精摄入量和发展HCC的风险之间的关联.
- 为了比较不同类别的HCC风险:非MASLD,MASLD,MASLD与增加的酒精摄入量 (MetALD) 和与酒精相关的肝病 (ALD).
主要方法:
- 在韩国共和国 (2009-2010年) 分析了6,412,209名40-79岁的参与者的大量队列.
- 参与者根据MASLD状态和酒精消费水平 (非MASLD,MASLD,MetALD,ALD) 进行分类.
- 多变量Cox比例危险模型被用于估计HCC风险,平均随访时间为13.3年.
主要成果:
- 与非MASLD相比,HCC风险从MASLD (aHR 1.66) 逐步增加到MetALD (aHR 2.17) 和ALD (aHR 2.34).
- 老年人和没有肝硬化的人更容易受到来自MASLD和/或酒精的HCC风险增加.
- 在老年人,女性和肝硬化亚组中,MetALD与ALD具有类似的HCC风险.
结论:
- 随着MASLD和增加酒精摄入量,HCC风险逐渐升级,最终导致ALD.
- 有效的HCC初级预防需要采用双重方法,既针对代谢功能障碍,也针对饮酒习惯.
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