负载后一小时的葡萄糖与活检证明的代谢功能障碍相关的肥胖个体肥胖性肝病有关
Fangqin Yuan1, Da Fang2, Hao Xu1
1Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China.
Diabetes & metabolism
|December 7, 2024
概括
在肥胖个体中,一小时后血葡萄糖 (1h-PG) 升高显著增加了代谢功能障碍相关的脂肪性肝病 (MASLD) 和代谢相关的脂肪性肝炎 (MASH) 的风险. 早期对MASLD进行查至关重要,即使在那些具有正常葡萄糖耐受性的患者中,如果1h-PG很高.
科学领域:
- 内分泌学 在内分泌学.
- 肝病学 肝病学是一种肝病学.
- 代谢疾病 代谢疾病
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 和与代谢相关的脂肪性肝炎 (MASH) 是严重的健康问题.
- 葡萄糖代谢的作用,特别是一个小时后的血葡萄糖水平 (1h-PG),在MASLD和MASH的发病过程中需要进一步研究.
研究的目的:
- 调查一小时负载后血葡萄糖水平 (1h-PG) 与MASLD和MASH的患病率之间的联系.
- 评估不同类别的葡萄糖耐受性中MASLD和MASH的风险,包括分层正常葡萄糖耐受性 (NGT) 组.
主要方法:
- 从538名肥胖参与者接受口服葡萄糖耐受性测试 (OGTT) 和肝脏活检的临床数据的回顾性分析.
- 参与者被分为正常葡萄糖耐受性 (NGT),糖尿病前期 (DM前期) 和2型糖尿病 (T2DM) 组,NGT进一步按1h-PG水平 (低与高) 分成.
- MASLD和MASH的诊断是基于NASH临床研究网络的评分系统;使用了后勤回归和调解分析.
主要成果:
- 随着葡萄糖耐受性恶化,MASLD和MASH的患病率逐渐增加 (NGT 1h-PG低
- 与NGT1h-PG低组相比,NGT1h-PG高组的MASLD和MASH风险明显更高,与DM前组相比.
- 升高的1h-PG水平与肝硬化,叶片炎症和纤维化相关;胰岛素敏感性和处置指数介导了1h-PG和肝硬化之间的关系.
结论:
- 升高的1h-PG水平是肥胖个体患MASLD和MASH的重要危险因素.
- 建议对MASLD进行早期查和治疗,特别是在正常耐葡萄糖但1h-PG水平升高 (≥8.6 mmol/l) 的个体.
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