记录的社会脆弱性对代谢功能障碍相关的脂肪性肝病的临床结果的影响
Pojsakorn Danpanichkul1, Yanfang Pang2,3,4, Maria Inggriani1
1Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
概括
社会脆弱性显著增加了肝脏和心血管并发症的风险,在患有代谢功能障碍相关的脂肪性肝病 (MASLD) 的患者中. 解决健康的社会决定因素 (SDoH) 对于改善MASLD患者的结果至关重要.
科学领域:
- 肝病学和心血管医学.
- 公共卫生与健康的社会决定因素
背景情况:
- 健康的社会决定因素 (SDoH),如贫困和孤立,影响慢性疾病的结果.
- SDoH对代谢功能障碍相关的脂肪性肝病 (MASLD) 的影响尚不清楚.
- 本研究调查了MASLD患者的社会脆弱性和健康结果之间的联系.
研究的目的:
- 评估MASLD患者的社会脆弱性与肝脏相关结果之间的关联.
- 评估MASLD患者的社会脆弱性与心血管结果之间的关联.
主要方法:
- 一项回顾性队列研究利用了 TriNetX 网络的非识别电子健康记录.
- 患有MASLD和有记录的社会脆弱性 (ICD-10代码Z59.5,Z59.6,Z56.0,Z60.2) 的患者与非脆弱个体进行了比较.
- 包括主要不良肝脏结果 (MALO),主要不良心血管事件 (MACE) 和肝细胞癌 (HCC) 在内的结果被追踪了5年.
主要成果:
- 在社会上脆弱的MASLD患者中,MALO (HR 1.69) 和MACE (HR 1.64) 的风险更高.
- 心血管疾病发病率升高包括心律失常 (HR 1.81) 和心力衰竭 (HR 1.64) 的风险增加.
- 在社会脆弱和非脆弱的MASLD患者之间没有观察到HCC发病率的显著差异.
结论:
- 记录的社会脆弱性是MASLD中肝脏和心血管并发症的独立风险因素.
- 将SDoH整合到MASLD管理和风险预测中,对于减少结果差异至关重要.
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