严重的肥胖与比瘦肉代谢功能障碍相关的脂肪性肝病更糟糕的结果有关
Jaideep Behari1,2,3, Renwei Wang3, Hung N Luu3,4
1Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Hepatology communications
|June 27, 2024
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 患者非常严重肥胖 (BMI ≥50 kg/m2) 面临肝脏衰竭,肥胖相关癌症和死亡率的最高风险. 即使是瘦身的MASLD患者,与正常体重患者相比,风险也增加了.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 肥胖医学 肥胖医学
- 临床流行病学临床流行病学
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 是一种普遍的疾病,特别是在肥胖的人群中.
- 了解身体质量指数 (BMI) 对MASLD临床结果的影响对于患者管理至关重要.
研究的目的:
- 调查各种身体质量指数 (BMI) 类别与一大群患有MASLD的患者的临床结果之间的关联.
- 确定较高的BMI是否与肝脏衰竭,特定癌症,肝脏移植和死亡率的风险增加有关.
主要方法:
- 追溯分析32,900名来自美国卫生系统的MASLD患者的电子健康记录.
- 患者被分为六个BMI类别 (<25,25-<30,30-<40,40-<50,和≥50公斤/米2).
- 平均随访时间为5.5年,以评估肝脏衰竭,肝外癌症,肝移植和全因死亡率.
主要成果:
- 在肝脏衰竭和与肥胖相关的肝外癌症中观察到J形风险概况.
- 与BMI<25 kg/m2和BMI≥50 kg/m2的患者相比,BMI为25-<30 kg/m2的患者,肝脏衰竭的调整HRs显著更高,而BMI为25-30 kg/m2.
- 对于所有原因的死亡率,还注意到了一个J形的关联,BMI≥50 kg/m2组的风险最高.
结论:
- 在MASLD患者中,非常严重的肥胖 (BMI ≥50 kg/m2) 与不良结果的最高风险有关,包括肝脏衰竭,肥胖相关的癌症和死亡率.
- 瘦身MASLD患者 (BMI <25 kg/m2) 与BMI 25-<30 kg/m2患者相比,对某些结果的风险也增加.
- 体重指数是影响MASLD患者预后的关键因素.
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