与代谢功能障碍相关的脂肪性肝病 (MASLD) 患者的sarcopenic内脏肥胖症
Maha Elsabaawy1, Amr Ragab2, Amal Abd-Elrazek3
1Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen Elkoom, Menoufia, Egypt. maha.ahmed@liver.menofia.edu.eg.
Clinical and experimental medicine
|October 21, 2025
概括
麻性内脏肥胖 (SVO) 影响了近一半的代谢功能障碍相关的脂肪性肝病 (MASLD) 患者,显著增加纤维化和心血管风险. 一个新的分层分类有助于个性化 MASLD 护理.
科学领域:
- 代谢医学是一种代谢医学.
- 肝病学 肝病学是一种肝病学.
- 心血管疾病 心血管疾病
背景情况:
- 麻性内脏肥胖 (SVO) 是代谢功能障碍相关的脂肪性肝病 (MASLD) 的高风险表型.
- 了解MASLD中SVO的流行率和影响对于风险分层和管理至关重要.
研究的目的:
- 在MASLD患者中确定MRI定义的SVO的患病率和代谢影响.
- 评估SVO与肝纤维化和心血管风险的相关性.
- 为个性化MASLD风险分层引入一种新的基于层级的分类.
主要方法:
- 对334名患有MASLD的成年人进行横截面研究.
- 通过生物电阻分析评估的肉;基于MRI的内脏脂肪面积 (VFA ≥100 cm2) 的内脏肥胖.
- 使用非侵入性指数和MRE评估肝纤维化;根据ASCVD得分评估心血管风险. 参与者分为SVO/非SVO和红/黄色/绿风险级别.
主要成果:
- 在42.5%的MASLD患者中存在SVO,在女性和BMI≥40的患者中更常见.
- SVO与更糟糕的代谢特征 (HOMA-IR),晚期纤维化 (FIB-4) 和更高的心血管风险 (ASCVD ≥7.5%) 相关.
- SVO独立预测了晚期纤维化 (OR=2.5),并且基于层级的模型确定了一个高风险的"红层"群体,患有F3-F4纤维化和糖尿病.
结论:
- 在MASLD中,SVO是一种流行且显著的表型,与不良的代谢,肝脏和心血管结果有关.
- 整合SVO,纤维化和ASCVD风险的新型分层风险框架为MASLD管理提供了个性化的方法.
- 这项研究为中东MASLD队列中SVO提供了第一个基于MRI的SVO脂肪和肉的综合评估,突出了其预后价值.
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