Eur Heart J:肝脂肪含量、非酒精性脂肪性肝病和缺血性心脏病!

2017-12-09 xing.T MedSci原创

尽管肝脏脂肪含量、NAFLD与IHD之间的观察性相关性已经确认,遗传性肝脏较高脂肪含量并不与IHD风险之间存在因果关系。这些结果表明观察性相关性是由于混杂或反向因果有关。

在观察性研究中,非酒精性脂肪性肝病(NAFLD)与缺血性心脏病(IHD)的高风险相关。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员旨在检验一个假设,即较高的肝脏脂肪含量或诊断NAFLD是IHD发生的危险因素。

在丹麦一般人群中进行的队列研究(n=94708,IHD 患者有10897人),研究人员首先检验较高的肝脏脂肪含量和诊断NAFLD是否与IHD之间存在观察性的相关性。随后,使用孟德尔随机化,研究人员检验编码含Patatin样磷脂酶域蛋白3(PNPLA3)的基因突变,I148M(rs738409,较高肝脏脂肪含量与NAFLD特异性原因),是否与IHD风险之间存在因果关系。

研究人员发现,随着肝脏脂肪含量(四分位数)增加,IHD的风险逐步增加,其比值比(OR)为2.41(1.28-4.51,趋势P=0.004)。NAFLD患者与无NAFLD的患者比较发生IDH相应的比值比为1.65(1.34-2.04)(P=3×10-6)。PNPLA3突变的 I148M与肝脏脂肪含量逐步增加相关(P=0.0001),对于非酒精性脂肪肝比值比为2.03(1.52-2.70)(P=3×10-7),对于肝硬化为3.28(2.37-4.54)(P=4×10-12),对于IHD为0.95(0.86-1.04)(P=0.46)。在荟萃分析中(n=279013, IHD为71698人),M-等位基因vs. I-等位基因的患者发生IHD的比值比为0.98(0.96-1.0)。M-等位基因遗传决定的肝脏脂肪含量对于IHD的比值比为0.98(0.94-1.03)高于观察性估计的1.05(1.02-1.09)(P=0.02)。

尽管肝脏脂肪含量、NAFLD与IHD之间的观察性相关性已经确认,遗传性肝脏较高脂肪含量并不与IHD风险之间存在因果关系。这些结果表明观察性相关性是由于混杂或反向因果有关。

原始出处:

Bo Kobberø Lauridsen,et al. Liver fat content, non-alcoholic fatty liver disease, and ischaemic heart disease: Mendelian randomization and meta-analysis of 279 013 individuals. Eur Heart J.2017. https://doi.org/10.1093/eurheartj/ehx662

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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268158, encodeId=5b7b2681586b, content=学习了谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Dec 09 19:36:51 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268158, encodeId=5b7b2681586b, content=学习了谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Dec 09 19:36:51 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
    2018-01-15 qjddjq
  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268158, encodeId=5b7b2681586b, content=学习了谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Dec 09 19:36:51 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
  8. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268158, encodeId=5b7b2681586b, content=学习了谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Dec 09 19:36:51 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
    2017-12-11 zhaojie88
  9. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268158, encodeId=5b7b2681586b, content=学习了谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Dec 09 19:36:51 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
    2017-12-11 slcumt
  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268158, encodeId=5b7b2681586b, content=学习了谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Dec 09 19:36:51 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
    2017-12-09 清风拂面

    学习了谢谢!

    0