与代谢功能障碍相关的脂肪肝炎在艾滋病毒感染者中表现出性别差异
Dana Kablawi1,2, Jovana Milic3, Tyler Thomas4
1Chronic Viral Illness Service, Division of Infectious Disease, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
HIV medicine
|August 2, 2024
概括
患有艾滋病毒的妇女在更年期左右的代谢功能障碍相关的脂肪肝炎 (MASH) 得分增加得更快,尽管最初的患病率较低. 这凸显了在MASH诊断和艾滋病毒感染者的治疗中需要考虑性别差异的必要性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 内分泌学 在内分泌学.
背景情况:
- 艾滋病毒感染者 (PLWH) 患有代谢功能障碍相关的脂肪肝炎 (MASH) 的风险较高.
- 在一般人群中,MASH的性别差异是已知的,但在PLWH中未得到充分研究.
研究的目的:
- 研究艾滋病毒感染者中MASH趋势的基于性别的差异.
- 分析年龄对MASH患病率和与性别相关的进展的影响.
主要方法:
- 一项多中心队列研究,对1472名没有病毒性肝炎共感染的艾滋病毒感染者进行.
- 与代谢功能障碍相关的脂肪肝炎 (MASH) 具有显著的肝纤维化 (F2-F4阶段),使用FibroScan-AST (FAST) 评分>0.35.5进行诊断.
- 分段线性混合效应模型分析了按年龄对MASH趋势的基于性别的差异,并调整了种族,糖尿病,高血压和可检测的HIV病毒载量.
主要成果:
- 基线纤维化MASH患病率在女性 (4.8%) 比男性 (9.2%) 低.
- 男性性别,年龄较大,可检测的HIV病毒载量和高血压与纤维化高MASH相关.
- 虽然男性的FAST分数总体较高,但女性的分数在40-50岁之间显著增加,到55岁时达到男性的水平.
结论:
- 艾滋病毒感染妇女在绝经前的年龄左右,MASH的进展显著加速.
- 在临床评估中必须考虑性别差异MASH在PLWH.
- 未来的研究应该专注于精准医学的性别特异性方法,用于在艾滋病毒感染者中管理MASH.
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