J Gastroenterology:身体代谢情况与非酒精性脂肪性肝炎与严重纤维化之间的关联

2020-03-08 MedSci原创 MedSci原创

背景和目标: 身体体重的不同代谢情况可能有助于预测患有非酒精性脂肪性肝病(NAFLD)的个体是否会发展为晚期肝病。本项研究探究了体重代谢表型与非酒精性脂肪性肝炎(NASH)和纤维化的关系。

背景和目标: 身体体重的不同代谢情况可能有助于预测患有非酒精性脂肪性肝病(NAFLD)的个体是否会发展为晚期肝病。本项研究探究了体重代谢表型与非酒精性脂肪性肝炎(NASH)和纤维化的关系。

方法: 本项横断面研究纳入了559名经肝活检证实的NAFLD患者(平均年龄53岁;女性51%)。评估了他们的NAFLD的临床,遗传和组织学特征。代谢不健康的表型定义为存在两个或多个代谢成分,而体重则根据体重指数分类:肥胖(≥25kg/m2)或非肥胖(<25 kg/m2)。体重代谢表型分为四个研究组:(1)非肥胖代谢综合征MS-,(2)非肥胖MS +,(3)肥胖MS-和(4)肥胖MS +。

结果: 肥胖MS-和非肥胖MS +组表现出差不多的胰岛素抵抗水平,脂肪组织胰岛素抵抗指数和内脏脂肪组织(VAT)区域。肥胖MS +组的内脏脂肪面积明显高于肥胖MS-组。但是,非肥胖MS +组的内脏脂肪与皮下脂肪组织(SAT)比率最高。非肥胖MS +,肥胖MS-和肥胖MS +组之间在组织学上没有差异。对年龄,性别,吸烟状况,PNPLA3,TM6SF2和VAT / SAT区域进行调整后的多变量分析表明,体重代谢表型与NASH或明显纤维化之间存在独立且呈剂量依赖性。

结论:非肥胖MS +组与肥胖的MS-组相比,肝脏组织学严重程度相似。肥胖以外的代谢环境可能在非肥胖的MS +个体中发挥致病作用,这些个体会发展出具有明显肝纤维化的NASH。

原始出处:

Donghee Kim. Et al. Association between body size-metabolic phenotype and nonalcoholic steatohepatitis and significant fibrosis. J Gastroenterology.2020.

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    2020-08-18 qjddjq
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    2020-04-25 许安
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