美国心脏协会(AHA):影响全球1/4成人,脂肪肝风险不止肝癌,主要死因居然还有冠心病!

2022-04-25 网络 网络

非酒精性脂肪肝疾病(NAFLD)的发病率和流行率在全球范围内迅速上升。

非酒精性脂肪肝疾病(NAFLD)的发病率和流行率在全球范围内迅速上升。据统计,全球NAFLD的患病率约为25%,从非洲的13%到东南亚的42%不等。NAFLD包括一系列疾病,包括非酒精性脂肪肝(NAFL)或单纯性脂肪变性(该病程较温和),以及非酒精性脂肪性肝炎(NASH),后者可发展为肝硬化甚至肝细胞癌(HCC)。

有研究分析,预计2016年至2030年,中国、法国、德国、意大利、日本、西班牙、英国和美国的NAFLD患病率将增加高达56%。NAFLD由代谢综合征驱动,与肥胖、胰岛素抵抗和高脂血症有关。肥胖和胰岛素抵抗导致慢性炎症、脂质代谢改变并促进HCC发生、发展。

近期,美国心脏协会(AHA)在所属杂志Arteriosclerosis, Thrombosis, and Vascular Biology上发表声明,呼吁大家重视并尽早识别NAFLD,同时提前预防NAFLD相关心血管及肝脏疾病。

基于NAFLD的发生与胰岛素抵抗(不仅是糖尿病)、肥胖(尤其是内脏脂肪增多)、代谢综合征、血脂异常等因素有关。因此,NAFLD发病率的升高与肥胖率以及代谢综合征发病率的升高呈现明显相关性。

值得关注的是,NAFLD不仅是冠心病ASCVD的独立风险因素,且存在严重NAFLD的患者,ASCVD相关风险疾病(如糖尿病、高血压等)的发生风险也明显升高,即NAFLD可增强ASCVD的风险作用

此外,尽管既往Meta分析的结果提示,NAFLD与全因死亡风险的升高有关,与心血管疾病死亡风险的升高无关。但近期相关分析研究结果证实,肝纤维化(F3~F4)与肝脏并发症和全因死亡的风险升高有关,而ASCVD是NAFLD患者死亡的主要原因。

索马鲁肽治疗效果

最后,AHA在文章中也指出如何对NAFLD进行干预。目前认为,包括戒酒、饮食干预、增加运动、减重在内的生活方式干预是关键。此外,近年来的研究也已表明,利拉鲁肽、索马鲁肽、吡格列酮、他汀在内的降脂药等都显示出了潜在的治疗效果,但目前尚未有药物获得FDA批准。

 

参考文献:

Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: A Scientific Statement From the American Heart Association. Arteriosclerosis, Thrombosis, and Vascular Biology. 2022;0:10.1161/ATV.0000000000000153

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1934179, encodeId=dc6519341e9d1, content=<a href='/topic/show?id=a23ce9798fe' target=_blank style='color:#2F92EE;'>#美国心脏协会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79798, encryptionId=a23ce9798fe, topicName=美国心脏协会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=50ba440, createdName=xirongguo, createdTime=Sun Apr 02 20:46:53 CST 2023, time=2023-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1233020, encodeId=a89d123302013, content=学习了,了解了疾病相关性研究 , beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Sun Jul 17 18:46:23 CST 2022, time=2022-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1214879, encodeId=279412148e953, content=<a href='/topic/show?id=890e8438e3e' target=_blank style='color:#2F92EE;'>#脂肪肝#</a>与<a href='/topic/show?id=370d8126914' target=_blank style='color:#2F92EE;'>#肝癌#</a><a href='/topic/show?id=77c33081e40' target=_blank style='color:#2F92EE;'>#冠心病#</a>,其实都有关联, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84387, encryptionId=890e8438e3e, topicName=脂肪肝), TopicDto(id=81269, encryptionId=370d8126914, topicName=肝癌), TopicDto(id=30817, encryptionId=77c33081e40, topicName=冠心病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Apr 26 21:48:39 CST 2022, time=2022-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1214077, encodeId=f6a912140e71c, content=***<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/gKNgZiaia7XBE8lJLn1fp5u443yIhUNiaN9RztibctRREAGYVEtL7eC22wG0DzYdDiaiaTAEg4HaotaF4icegqk4VQvCA/132, createdBy=d6182579909, createdName=西瓜0628, createdTime=Mon Apr 25 12:07:25 CST 2022, time=2022-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268822, encodeId=303412688227c, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Apr 22 01:46:53 CST 2022, time=2022-04-22, status=1, ipAttribution=)]
    2022-07-17 ms6000001791212108

    学习了,了解了疾病相关性研究

    0

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    2022-04-26 病毒猎手

    #脂肪肝##肝癌##冠心病#,其实都有关联

    0

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    2022-04-25 西瓜0628
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    2022-04-22 zhaohui6731

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