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肝脏不良结果,心血管事件,以及肥胖性肝病的死亡率
Pedro Ochoa-Allemant1, Rebecca A Hubbard2, David E Kaplan1,3
1Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
患有代谢功能障碍相关的脂肪性肝病 (MASLD) 和酒精相关的肝病 (ALD) 或它们的交叉 (MetALD) 的患者面临更高的肝脏问题和死亡风险. 酒精和纤维化评估可以识别有风险的个体.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 心血管医学 心血管医学
- 公共卫生 公共卫生
背景情况:
- 脂肪性肝病 (SLD) 是导致晚期肝病和不良长期健康结果的重要因素.
- 使用修订的命名法,对SLD亚型的基于人口的数据是有限的.
- 了解各种亚型的风险,如与代谢功能障碍相关的脂肪性肝病 (MASLD),与酒精相关的肝病 (ALD) 和它们的交叉点 (MetALD) 是至关重要的.
研究的目的:
- 为了比较SLD亚型中不良肝脏结果,主要不良心血管事件 (MACE) 和全因死亡率的风险.
- 评估酒精使用和纤维化对这些结果的影响.
主要方法:
- 对341,601名成年人进行了回顾性队列研究,这些成年人患有图像确认的肝肥胖症.
- 使用了退伍军人卫生管理局 (2010-2021) 的数据.
- 分析的亚型:MASLD,MetALD和ALD. 这些亚型包括: 结果包括肝病进展,MACE和死亡率.
主要成果:
- 与MASLD相比,MetALD和ALD的肝脏不良结果发生率和全因死亡率较高.
- 在所有研究的SLD亚型中,MACE发生率相似.
- 较高的纤维化得分 (纤维化-4>2.67) 显著增加了所有亚型的不良肝脏结果;严重的酒精使用,酒精使用障碍和糖尿病是关键风险因素.
结论:
- 与MASLD相比,患有MetALD和ALD的患者的肝脏不良结果和全因死亡率的风险略高.
- 在这些SLD亚型中,MACE风险似乎是可比的.
- 综合酒精和纤维化评估对于识别患有较高长期不良结果风险的患者至关重要.
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