使用脂肪性肝病框架重新分类儿科NAFLD:来自NASH CRN的多中心回顾性研究
Tin Bo Nicholas Lam1,2, Katherine P Yates3, Sheila L Noon1
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, CA.
Hepatology (Baltimore, Md.)
|October 17, 2025
概括
大多数被诊断患有非酒精性脂肪性肝病 (NAFLD) 的儿童符合与代谢功能障碍相关的脂肪性肝病 (MASLD) 的标准. 然而,由于酒精或药物使用,有些需要重新分类.
科学领域:
- 儿科肝病学 儿科肝病学
- 代谢性肝病 代谢性肝病
- 肝脏组织病理学 肝脏组织病理学
背景情况:
- 修订了肥胖性肝病 (SLD) 术语,将代谢功能障碍相关的肥胖性肝病 (MASLD) 作为主要亚型.
- MASLD是由肝硬化症加上心脏代谢风险因素 (CMRFs) 定义的.
- 新的SLD框架在儿科患者群体中的适用性需要研究.
研究的目的:
- 评估修订后的SLD框架在被诊断为NAFLD的儿童中的适用性.
- 使用MASLD和相关标准重新分类儿科NAFLD病例.
- 确定儿童中MASLD和替代性SLD亚型的流行率.
主要方法:
- 对1019名临床诊断为NAFLD的儿童和肝脏组织学进行了回顾性分析.
- 对临床数据的审查,包括BMI,药物使用和酒精摄入量.
- 肝脏活检的中央审查,以确认肥胖症并排除其他原因;使用SLD标准进行重新分类.
主要成果:
- 84%的NAFLD儿童符合MASLD标准,平均为2.7个CMRF.
- 3.2%被重新归类为Met-ALD (酒精含量低于ALD值的MASLD).
- 6.5%被重新分类为药物诱导的SLD;5.4%的青少年是Met-ALD.
结论:
- 大多数儿科NAFLD病例符合MASLD标准.
- 显著的少数人需要因酒精消费或药物暴露而重新分类.
- 强调需要全面的诊断评估,考虑到代谢,酒精和药物因素.
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