基于人口的研究,研究了与代谢功能障碍相关的脂肪性肝病和慢性病的共存
Rachel Sze Jen Goh1, Jaycie Koh2, Made Ayu Utami Intaran3
1Yong Loo Lin School of Medicine National University Singapore Singapore Singapore.
Journal of the American Heart Association
|September 19, 2025
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 和慢性病 (CKD) 共同显著增加死亡风险. 早期发现和管理共存的MASLD和CKD对于改善患者的治疗结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 和慢性病 (CKD) 被认为是显著的心血管风险因素.
- 同时存在的MASLD和CKD对死亡率和心脏代谢结果的综合预后影响尚未得到充分证实.
研究的目的:
- 调查MASLD和CKD对所有原因死亡率和心脏代谢疾病发病率的独立和联合影响.
- 评估MASLD和CKD表型之间的关联以及主要心血管不良事件和癌症的风险.
主要方法:
- 利用国家健康和营养检查调查 (NHANES) 2007-2018数据库对大量成年人群进行了调查.
- 采用考克斯回归模型来分析MASLD/CKD状态和死亡率之间的关系,调整为关键的人口和临床变量.
- 进行了敏感性分析,包括肝纤维化标志物和CKD阶段.
主要成果:
- 在MASLD(+) /CKD(+) 现型中,肥胖,高血压,失脂症和糖尿病的患病率最高,冠状动脉疾病和心力衰竭的风险增加.
- 患有同时存在的MASLD和CKD以及单独患有MASLD和单独患有CKD的个体,与没有任何条件的人相比,具有明显更高的全因死亡风险.
- 人们注意到社会经济差异,低收入人群在MASLD ((+) /CKD ((+) 组中占有不成比例的比例.
结论:
- 随着MASLD和CKD (MASLD(+) /CKD(+)) 的同时发生,可以独立预测所有原因死亡率的增加,并与心脏代谢多病率的更高相关.
- 在肝纤维化和慢性结核病的严重程度增加的个体中,观察到死亡风险逐渐恶化.
- 研究结果强调,对于患有共存MASLD和CKD的患者,有必要制定综合管理策略,以减轻不良健康结果.
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