超越BMI:揭示了瘦肉MASLD中的代谢风险
Adrian Rotaru1,2, Ermina Stratina1,2, Laura Huiban1,2
1Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.
Archive of clinical cases
|August 5, 2025
概括
瘦身代谢功能障碍相关的脂肪性肝病 (MASLD) 影响了东欧近20%的正常体重个体. 这种情况带来了显著的代谢问题,突出了除身体质量指数 (BMI) 外的查需求.
科学领域:
- 肝病学和代谢疾病
- 公共卫生和流行病学
背景情况:
- 代谢功能障碍相关的脂肪性肝病 (MASLD) 通常与肥胖有关.
- 在正常体重的个体中存在显著的MASLD负担,称为"瘦MASLD".
- 身体质量指数 (BMI) 可能无法充分识别所有面临MASLD风险的人.
研究的目的:
- 为了确定在东欧人口中瘦肉肌肌肉疾病的流行率.
- 为了描述瘦肉MASLD的代谢和肝脏特征.
- 评估MASLD的BMI中心查的诊断局限性.
主要方法:
- 一项对1438名成年人进行的观察性研究,包括全面的代谢和肝脏评估.
- 用于肝脏评估的控制衰减参数 (CAP) 的振动控制过时弹性图 (VCTE).
- 对正常体重子组 (BMI <25 kg/m2) 的分析,包括身体脂肪组成的CUN-BAE指数和非侵入性得分 (FLI,HSI,FIB-4,APRI,NFS).
主要成果:
- 在正常体重的个体中,MASLD在19.28%的个体中被发现,这表明患病率很高.
- 瘦身MASLD队列表现出显著的代谢功能障碍:高血压 (26.47%),高胆固醇 (46.54%) 和2型糖尿病 (18.38%).
- 内脏脂肪 (CUN-BAE评分) 预测了肝肥胖症;非侵入性评分显示了瘦个体中适度的区分能力.
结论:
- 在东欧,瘦身 MASLD 是一种未被认可的疾病,通常会出现代谢障碍.
- 单独的BMI不足以进行MASLD查,可能会延迟诊断和干预.
- 整合内脏脂肪性评估和先进的非侵入性肝脏评估对于早期检测和风险分层至关重要.
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