MASLD与代谢综合征之间的代谢分歧:明显的临床表型和风险分层的影响
Mariana M Ramírez-Mejía1,2, Sandra M Barbalho3, Guadalupe Ponciano-Rodríguez4
1Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
概括
与代谢功能失调相关的脂肪性肝病 (MASLD) 显示出显著的患者异质性. 基于表型的方法,而不是单独的代谢综合征,可以改善MASLD患者的风险分层.
科学领域:
- 肝病学
- 代谢疾病
- 临床研究
背景情况:
- 代谢功能障碍相关的脂肪酸性肝病 (MASLD) 是全球慢性肝病的首要原因.
- 代谢综合征 (MetS) 是一个传统的指标,但可能不完全代表MASLD的风险范围.
- 了解MASLD的临床异质性对于有效管理至关重要.
研究的目的:
- 探索MASLD中的表型异质性.
- 调查MASLD和MetS之间的重叠和分歧.
- 改善MASLD患者的临床分层.
主要方法:
- 在发现队列 (n=600) 中使用了无监督集群方法.
- 分析了标准化的临床和代谢变量,以确定不同的表型.
- 在独立的队列中进行了外部验证 (n=407).
主要成果:
- 一个分为两个集群的模型确定了低风险和高风险群体 (对MASLD和MetS进行了丰富).
- 一个三集群模型揭示了MASLD但没有MetS的中间组,表现出不同的代谢特征.
- 集群结构得到验证,集群成员与肥胖和纤维化参数相关.
结论:
- MASLD表现出显著的表型异质性,部分与MetS不同.
- 单独使用MetS可能无法完全捕捉MASLD中的代谢功能障碍谱.
- 使用临床和代谢数据的基于表型的策略可以增强MASLD风险分层和个性化治疗.
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