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与代谢功能障碍相关的脂肪性肝病的西班牙裔成年人查和风险分层的差异

Monica A Tincopa¹, Luis Antonio Díaz^1,2, Daniel Q Huang^1,3,4

¹MASLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California at San Diego, La Jolla, California, USA.

Hepatology (Baltimore, Md.)

|October 18, 2024

概括

在西班牙裔个体中,对代谢功能障碍相关的脂肪性肝病 (MASLD) 需要较低的非侵入性测试切断点. 目前的值低估了这一群体中显著的纤维化,需要优化查以获得更好的健康结果.

科学领域:

肝病学肝病学是一种肝病学.
医疗成像医学成像
临床诊断临床诊断临床诊断

背景情况:

目前针对代谢功能障碍相关的脂肪性肝病 (MASLD) 纤维化风险分层的非侵入性测试使用来自非西班牙裔人口的切割点.
在患有MASLD的西班牙裔个体中,这些既定切断点的表现尚不清楚.
这项研究旨在评估和优化西班牙裔患者的非侵入性测试性能.

研究的目的:

评估目前的非侵入性测试切割点的诊断准确性,以评估MASLD的西班牙裔患者显著纤维化.
确定优化的切断点是否可以改善这一人口群体中的风险分层.
为了比较磁共振弹性图 (MRE) 和振动控制的短暂弹性图 (VCTE) 在西班牙裔与非西班牙裔个体的性能.

主要方法:

预计将招募244名成年人进行活检证明的MASLD.
评估了磁共振弹性图 (MRE) 和振动控制的短暂弹性图 (VCTE) 的性能.
使用AUROC评估的诊断性能,通过Youden J分析确定最佳切割点;在拉丁美洲队列中验证的发现.

主要成果:

与非西班牙裔个人相比,西班牙裔参与者 (31%) 的MRE (AUROC 0.87对0.98) 和VCTE (0.78对0.92) 准确度明显较低.
临床算法导致西班牙裔患者晚期纤维化错误阴性率高.
在西班牙裔个体中显著纤维化的最佳切割点被确定为MRE的2.73kPa和VCTE的6.9kPa.

结论:

已经确立的MASLD纤维化非侵入性测试切割点可能无法充分识别西班牙裔人口中的疾病.
建议将MRE和VCTE的切割点降低,以改善西班牙裔个人的监测.
鉴于在这个人口群体中观察到的疾病负担和严重程度较高,这些调整至关重要.

关键词:

西班牙裔西班牙裔.马什 (MASH) 是一个非常重要的产品.马斯尔德马斯尔德是什么意思在健康方面存在差异.非侵入性测试是一种非侵入性测试.

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