在维生素E治疗代谢功能障碍相关的脂肪性肝病期间,细微的铁缺乏症的发展
Maren C Podszun1, Ahmad Samer Alawad1, Shilpa Lingala1
1Liver & Energy Metabolism Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Journal of dietary supplements
|February 17, 2025
概括
维生素E治疗脂肪肝疾病 (MASLD) 经常导致缺铁和贫血,通常与胃肠道出血有关. 监测至关重要,特别是对于糖尿病患者来说,因为缺乏症可以通过护理解决.
科学领域:
- 肝病学和胃肠道学
- 营养生物化学 营养生物化学
- 临床医学 临床医学
背景情况:
- 维生素E被认为可以治疗与代谢功能障碍相关的脂肪肝炎 (MASH).
- 然而,维生素E的使用与其他情况下的出血并发症有关.
- 在对代谢功能障碍相关的脂肪性肝病 (MASLD) 进行维生素E治疗期间,铁缺乏症的风险仍未得到充分研究.
研究的目的:
- 调查MASLD维生素E治疗期间缺铁的发生率和特征.
- 探索与维生素E诱导的铁缺乏相关的潜在机制和风险因素.
主要方法:
- 在20名接受200-800 IU/天维生素E治疗的MASLD患者中,对铁状况的前性监测.
- 评估肝脏组织学,肝脏基因表达,氧化应激标志物 (4-hydroxynonenal),哈普托格洛宾基因型和血维生素E水平.
- 评估胃肠道出血源和子组分析 (糖尿病患者与非糖尿病患者).
主要成果:
- 55%的受试者在平均11周内出现铁缺乏症;30%的受试者出现贫血.
- 观察到费里丁和平均体积 (MCV) 显著下降,红细胞分布宽度 (RDW) 增加.
- 在75%的评估患者中发现了隐性胃肠道出血; 糖尿病患者中缺铁更为普遍.
结论:
- 隐性胃肠道出血和随后的铁缺乏是MASLD维生素E治疗的常见并发症.
- 这些发现表明维生素E对血小板功能的潜在影响,需要密切监测,特别是在最初的几个月.
- 铁缺乏症是可以管理和可逆的适当的干预,即使继续维生素E治疗.
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