在慢性乙肝患者中,代谢性并发症与纤维化严重程度和纤维化回归的关联
Lisa M van Velsen1, Lesley A Patmore1, Jordan J Feld2
1Department of Gastroenterology & Hepatology, Erasmus Medical Center, Rotterdam, Netherlands.
概括
代谢性并发症使慢性乙型肝炎 (CHB) 患者的肝纤维化恶化. 这些情况还阻碍了纤维化回归,并在抗病毒疗法 (AVT) 后增加进展风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
- 病毒性肝炎研究研究
背景情况:
- 代谢性并发症与慢性乙型肝炎 (CHB) 的不良结果有关.
- 代谢并发症对CHB肝纤维化严重性的影响尚不清楚.
研究的目的:
- 在未经治疗的CHB患者中调查代谢性并发症和肝纤维化严重程度之间的关联.
- 检查代谢并发症对纤维化回归和抗病毒治疗 (AVT) 后进展的影响.
主要方法:
- 分析了来自多个临床中心和试验的3179名未经治疗的CHB患者的活检数据.
- 评估纤维化严重程度与代谢状况的关系,如超重,高血压,糖尿病和脂质失调.
- 在启动AVT后评估纤维化变化 (回归/进展),与并发症状况相关.
主要成果:
- 代谢性并发症 (超重,高血压,糖尿病,脂质失调) 与未经治疗的CHB患者中晚期肝纤维化风险显著增加有关.
- 晚期纤维化风险随着并发症数量的增加而增加 (1并发症:aOR 1.115;≥2并发症:aOR 1.627).
- 与没有AVT的患者相比,具有代谢性并发症的患者在AVT后表现出较少的纤维化回归 (1并发症:31.6%;≥2:17.0%) 和更高的进展风险 (≥2并发症:14.3%).
结论:
- 代谢性并发症与未经治疗的CHB患者的更严重的肝纤维化有关.
- 在接受AVT的CHB患者中,代谢性并发症与纤维化回归的减少和纤维化进展的风险增加有关.
- 这些发现强调了在CHB管理中管理代谢健康的重要性.
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