在患有MASLD的个体中,纵向体重变化与临床结果之间的关联
Yu Shi1, Ruoqi Zhou1, Seung Up Kim2
1The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China.
Hepatology (Baltimore, Md.)
|October 8, 2025
概括
体重增加增加了与肝脏相关的事件风险和与代谢功能障碍相关的脂肪性肝病 (MASLD) 中的肝硬度. 相反,减肥可以改善肝硬度,并改变事件风险,特别是在肥胖逆转时.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 代谢疾病 代谢疾病
- 临床研究 临床研究
背景情况:
- 体重管理对于与代谢功能障碍相关的脂肪性肝病 (MASLD) 至关重要.
- 动态体重变化显著影响MASLD的进展和结果.
- 了解体重变化模式是改善患者管理的关键.
研究的目的:
- 评估MASLD患者的动态体重变化与肝脏相关事件 (LREs) 之间的关联.
- 评估体重波动对肝硬度进展和改善的影响.
- 根据肥胖状况过渡来分析LREs的风险.
主要方法:
- 分析了来自10,014名成年MASLD患者的数据,其中至少有两次体重测量.
- 重量变化分类为稳定 (≤5%),损失 (>5%) 和增益 (>5%).
- 使用回归模型评估肥胖状况变化 (持续性,过渡性) 和它们与LREs和肝硬度的相关性.
主要成果:
- 体重增加 (>5%) 显著增加了LREs的风险 (aHR=1.84) 和肝硬性进展 (aOR=2.07).
- 体重减轻 (>5%) 与肝硬度的改善有关.
- 虽然持续的肥胖增加了LREs的风险,但肥胖逆转显示了与持续的非肥胖相比的风险.
结论:
- 在MASLD中,体重增加是有害的,增加了LREs风险和肝硬度.
- 减肥提供了显著的好处,改善肝硬度,并可能减轻LRE风险.
- 在MASLD患者中实现肥胖逆转可以有利地改变LRE风险.
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