胰岛素样生长因子-1在肝硬化中与肝功能障碍和纤维化有关,并预测肝脏相关的死亡率
Lukas Hartl1,2,3, Michael Schwarz1,2, Benedikt Simbrunner1,2,3,4
1Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Alimentary pharmacology & therapeutics
|September 21, 2024
概括
在晚期慢性肝病 (ACLD) 中,较低的胰岛素样生长因子-1 (IGF-1) 水平表明肝功能受损,并预测脱补偿,急性至慢性肝衰竭 (ACLF) 和死亡. 这在肥胖症中尤为重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 生物化学 生物化学
背景情况:
- 晚期慢性肝病 (ACLD) 的特点是肝功能受损.
- 胰岛素样生长因子-1 (IGF-1) 信号传递在代谢调节和组织修复中起作用.
- 了解ACLD中的IGF-1动态对于评估疾病严重程度和预后至关重要.
研究的目的:
- 在晚期慢性肝病 (ACLD) 患者中特征胰岛素样生长因子-1 (IGF-1) 信号.
- 研究IGF-1水平与临床参数之间的关联,包括肝功能,纤维化和门性高血压.
- 评估IGF-1对肝脏相关结果的预测价值.
主要方法:
- 一项前性研究,包括269名接受肝静脉压梯度 (HVPG) 测量的患者.
- 患者被分类为从可能的ACLD (pACLD) 到严重失补偿 (S5) 的阶段.
- 测量IGF-1水平并与临床数据相关联,包括BMI,增强性肝纤维化 (ELF) 测试,MELD得分和年龄.
主要成果:
- 中位数IGF-1水平随着肝硬化程度的进展显著下降 (p < 0.001).
- 临床显著的门高血压 (CSPH) 患者的IGF-1水平较低 (p = 0.001).
- IGF-1显示出与BMI,ELF,MELD和年龄的独立负相关性. 它对6个月的肝脏相关死亡有很好的预测 (AUROC 0.856).
结论:
- 降低的IGF-1水平反映了肝功能受损和肝硬化中的纤维化.
- 低IGF-1独立地与高BMI相关,这表明在肥胖中具有相关性.
- 较低的IGF-1水平预示着肝硬化患者的脱补偿,ACLF和肝脏相关死亡.
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