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在IBD患者中,与MASLD,MASLD类型和不同心脏代谢风险因素相关的死亡风险:长期前性队列研究
Qian Zhang1, Yutao Wang1, Si Liu1
1Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; State Key Laboratory of Digestive Health; National Clinical Research Center for Digestive Diseases, Beijing, 100050, China.
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 在炎症性肠病 (IBD) 患者中显著增加死亡风险. 这种风险随着更多的心脏代谢风险因素而升级,并且在瘦肉的MASLD患者中显著增加.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 内部医学 内部医学
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 越来越多地被认为是严重的健康问题.
- 炎症性肠病 (IBD) 与各种肠外表现有关,包括肝脏疾病.
- MASLD和IBD之间的相互作用及其对长期死亡率的影响仍然是一个需要进一步研究的领域.
研究的目的:
- 调查MASLD与IBD患者全因死亡率之间的关联.
- 探索MASLD类型 (纯MASLD,MetALD),身体成分 (瘦/非瘦) 和心脏代谢风险因素 (CMRFs) 对IBD队列中的死亡风险的影响.
主要方法:
- 一项长期前性队列研究包括4622名没有其他肝病或癌症的IBD患者.
- 根据当前的标准,在基线评估了MASLD,MASLD类型,瘦身/非瘦身状态和CMRF.
- 考克斯的比例危险模型被用来分析与所有原因死亡率的关联.
主要成果:
- 38.1%的IBD患者患有MASLD.
- 与仅患IBD的患者相比,MASLD与58%的死亡风险增加有关 (HR=1.58).
- 随着CMRF数量的增加,死亡风险显著增加 (P趋势=0.005),3+CMRF的风险更高.
- 纯粹的MASLD (HR=1.62) 和MetALD (HR=2.03) 均显示死亡率升高.
- 瘦身MASLD (HR=3.14) 的死亡风险明显高于非瘦身MASLD (HR=1.67).
结论:
- 囊括纯MASLD和MetALD的MASLD与IBD患者的死亡率增加有关.
- 患有MASLD的IBD患者的死亡风险被越来越多的CMRF放大.
- 在这个队列中,瘦身MASLD患者的死亡风险特别高.
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