心脏代谢风险因素和肝硬化病的临床过程
Michele Esposito1, Raffaele Buono1, Paolo Angeli1
1Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine - DIMED, University of Padova, Padova, Italy.
患有心脏代谢风险因素 (CMRF) 和肝硬化症的患者面临类似的脱补偿率,但死亡率更高. 过高甘油三血症显著增加了这些患者脱补偿和死亡的风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 心脏病学 心脏病学
- 代谢综合征是代谢综合征的一种.
背景情况:
- 由于心脏代谢风险因素 (CMRF) 的增加,代谢功能障碍相关的肝病 (MASLD) 的患病率在全球范围内正在上升.
- 了解CMRFs对肝硬化进展的影响对于患者管理至关重要.
研究的目的:
- 研究CMRFs患者肝硬化的自然过程.
- 评估CMRFs对肝硬化不补偿,肝细胞癌发展和死亡率的影响.
主要方法:
- 从1998年到2022年,对667名肝硬化患者进行了随访.
- 患者根据CMRFs的存在 (2型糖尿病,肥胖,高血压,低HDL,高甘油三血) 和非代谢性病因因素进行了分类.
- 结局包括肝硬化不补偿,肝细胞癌和全因死亡率.
主要成果:
- 与没有CMRF的患者相比,CMRF患者的肝硬化失补偿和肝细胞癌的发病率与没有CMRF的患者相似.
- 然而,CMRF患者的全因死亡率显著上升,3年生存率降低.
- 过高甘油三和低高血糖水平与失补偿的最高风险有关,而过高甘油三也增加了死亡风险.
结论:
- 肝硬化患者的心脏代谢风险因素不会改变脱补偿率,但会显著增加整体死亡率.
- 过高甘油三血是肝脏衰竭和死亡的一个关键风险因素.
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