使用从大型现实世界数据集中例行收集的生物标志物进行IBD相关肝病风险分层
Zachary Green1,2, Alex Z Kadhim1, Lynn Win1
1Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, England, UK.
BMJ open gastroenterology
|November 13, 2025
概括
在炎症性肠病 (IBD) 诊断时,像ALT和ALP这样的常规血液检查可以确定患有IBD相关肝病 (IBALD) 风险的患者. 持续的异常水平需要进一步调查,以早期诊断和更好的结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 生物标志物研究 生物标志物研究
背景情况:
- 与炎症性肠病相关的肝病 (IBDALDs) 呈现异质,经常延迟诊断,导致严重的肝胆损伤和恶性病变.
- 早期识别和IBDALD风险分层对于及时干预和改善患者结果至关重要.
- 常规收集的生物标志物可能提供一种非侵入性的风险分层方法.
研究的目的:
- 评估在IBD诊断时和IBD风险分层的随访期间例行收集的生物标志物的实用性.
- 确定特定的生物标志物水平和纵向趋势是否可以预测IBDALD的发展.
主要方法:
- 一项观察性回顾性纵向研究,涉及1571名IBD患者.
- 生物标志物的分析,包括胺转移酶 (ALT),性酸酶 (ALP) 和红细胞沉积率 (ESR),在IBD诊断后±6个月内收集.
- 采用了匹配的病例控制设计,使用LOESS和线性混合效应模型 (LMM) 评估纵向趋势.
主要成果:
- 在IBD诊断时,后来患上IBDALD的患者表现出显著升高的ALT,ALP和ESR水平.
- 在IBD诊断时异常的ALT和ALP水平与IBDALD风险增加密切相关 (OR=5.10对于ALT,OR=15.33对于ALP).
- 在IBDALD发育之前观察到明显的纵向生物标志物轨迹 (ALT,ALP).
结论:
- 在IBD诊断时常规收集的生物标志物数据,特别是ALT和ALP,可以有效地分层IBD风险患者.
- 持续升高的ALT和ALP需要更密切的监测和可能更早的肝胆检查.
- 利用生物标志物趋势可以帮助减少诊断延迟,改善IBDALD的管理.
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