没有晚期肝纤维化SLD患者的BMD增加:来自NHANES 2017-2020数据库的证据
Tianhao Wu1, Lu Li2, Yayuan Mei3
1Department of Orthopedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang 050051, Hebei, China.
Canadian journal of gastroenterology & hepatology
|August 20, 2025
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 和其他脂肪性肝病 (SLD) 子类显示出与骨矿物质密度 (BMD) 的积极联系. 然而,肝纤维化可能会影响这种关联,需要进一步研究.
科学领域:
- 肝病学和骨代谢 肝病学和骨代谢
背景情况:
- 代谢功能障碍相关的脂肪性肝病 (MASLD) 是一个新的术语,取代了非酒精性脂肪性肝病 (NAFLD).
- 脂肪性肝病 (SLD) 子类别的临床意义及其对骨质的影响仍然不清楚.
研究的目的:
- 调查SLD亚类与骨质之间的关联.
- 探索肝脏脂肪量化 (CAP) 和硬度 (LSM) 与骨矿物质密度 (BMD) 之间的关系.
主要方法:
- 在4237名美国成年人 (2017-2020年NHANES) 的横截面分析中,使用振动控制过时弹性图 (VCTE) 和DXA.
- 权衡的通用线性和添加模型分析了SLD子类,CAP,LSM和骨参数 (BMC,骨面积,BMD).
主要成果:
- 所有SLD亚组 (MASLD,MetALD,ALD) 与股骨和脊柱的骨矿物质含量 (BMC) 和BMD正相关.
- 控制减弱参数 (CAP) 与骨硬度有很强的正相关性,而肝硬度测量 (LSM) 则显示混合关联,可能非线性,受纤维化影响.
- 亚组分析表明,在特定条件下,CAP与骨硬化有积极的相关性,而LSM与骨硬化之间的关联因纤维化严重程度和性别而异.
结论:
- 脂肪性肝病 (SLD) 与骨矿物质密度 (BMD) 有积极的关联.
- 肝纤维化似乎是影响SLD-BMD关系的重要因素.
- 需要进一步进行大规模的纵向研究,以充分了解肝脏肥胖症对骨健康的影响.
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