对代谢功能障碍相关的脂肪性肝病和代谢功能障碍相关的脂肪性肝炎的最佳买入:全球Delphi研究
Jeffrey V Lazarus1, Leire Agirre-Garrido2, Trenton M White3
1City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
专家们确定了与代谢功能障碍相关的脂肪性肝病 (MASLD) 和与代谢功能障碍相关的脂肪性肝炎 (MASH) 的关键干预措施,作为潜在的WHO最佳买入. 这些战略旨在将肝脏健康纳入非传染性疾病行动计划,以产生全球影响.
科学领域:
- 肝病学和公共卫生
- 非传染性疾病的预防和预防.
- 全球卫生政策 全球卫生政策
背景情况:
- 代谢功能障碍相关的脂肪性肝病 (MASLD) 影响全球三分之一的成年人,其中20-25%进展为代谢功能障碍相关的脂肪性肝炎 (MASH).
- 目前,MASLD和MASH被排除在世卫组织非传染性疾病全球行动计划之外,尽管它们对健康造成了重大负担.
- 这项研究旨在确定适合世卫组织最佳购买和快速购买状态的MASLD和MASH干预措施.
研究的目的:
- 确定针对MASLD和MASH的基于证据的干预措施,这些干预措施符合世卫组织的最佳购买标准.
- 评估这些干预措施作为快速购买与快速公共卫生影响的实施潜力.
- 为全球卫生政策提供信息,并将肝脏健康纳入非传染性疾病战略.
主要方法:
- 一个核心小组在全面的文献审查后,开发了15个基于证据的干预简报.
- 一个全球利益相关者小组使用单一的Delphi轮评估了干预措施的可行性和影响.
- 通过在小组成员之间达成80%或更高的联合协议来建立共识.
主要成果:
- 来自85个国家的321名专家参加了这次会议,所有15次干预都达到了共识 (>86%的同意).
- 评分最高的最佳买入干预措施是管理MASLD患者的超重,肥胖和2型糖尿病 (99%的同意).
- 在2型糖尿病患者中,肝纤维化常规查成为最受认可的快速购买 (88%的同意).
结论:
- 全球专家一致认为,许多MASLD和MASH干预措施符合世卫组织的最佳选择.
- 这些发现为决策者提供了一份路线图,将肝脏健康纳入NCD议程,解决健康不平等问题.
- 优先考虑这些干预措施可以催化行动,减少慢性肝病的负担,并加强全球卫生系统.
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