JGH: 内脏肥胖是活体供肝者出现非酒精性脂肪肝的危险因素

2021-07-03 MedSci原创 MedSci原创

随着不健康生活方式、肥胖、糖尿病和代谢综合征等的全球化流行,近20余年来非酒精性脂肪性肝病(NAFLD)及其严重类型非酒精性脂肪性肝炎(NASH)。

      随着不健康生活方式、肥胖、糖尿病代谢综合征等的全球化流行,近20余年来非酒精性脂肪性肝病(NAFLD)及其严重类型非酒精性脂肪性肝炎(NASH)已成为慢性肝病愈来愈重要的病因,严重危害公众健康。非酒精性脂肪性肝病(NAFLD)是指除外酒精和其他明确的损肝因素所致的肝细胞内脂肪过度沉积为主要特征的临床病理综合征。本研究旨在通过活检评估的肝脂肪变性 (HS) 与通过CT评估的瘦活肝供体候选者的内脏肥胖之间的关系,并确定瘦肉非酒精性脂肪性肝病 (NAFLD) 的危险因素。

 

      这项回顾性研究包括了 250 名瘦体质的(体重指数,<23 kg/m2)潜在活体肝脏捐献者(平均年龄,31.1±8.6 岁;141 名男性),他们在 2017 年至 2018 年期间接受了肝活检和腹部 CT检测,包括人体测量学,实验室参数、身体成分和 HS 的程度。Logistic 回归用于确定瘦 NAFLD 的独立预测因素。

 

 

      研究发现患者内脏脂肪面积(VFA)与男性(r =0.408;P <0.001)和女性(r =0.360;P <0.001)的HS程度显着相关。男性皮下脂肪面积(SFA)与HS程度显着相关(r =0.398;P <0.001),女性中则没有这样的联系。骨骼肌面积与男性或女性的 HS 程度无关。在多变量逻辑回归分析中,VFA(优势比 [OR],1.028;95% 置信区间 [CI],1.013–1.044;P <0.001)和 SFA(OR,1.016;95% CI,1.004–1.028;P =0.009) 是男性出现 NAFLD 的独立危险因素,而VFA (OR, 1.036; 95% CI, 1.013–1.059;P = 0.002) 是女性瘦 NAFLD 的独立危险因素。

图:内脏脂肪是瘦体质患者发生脂肪肝的危险因素

      在瘦体质的亚洲人群中,非酒精性脂肪肝的严重程度与内脏脂肪堆积呈正相关。内脏肥胖可能是潜在活体肝脏捐献者发生 NAFLD 的危险因素。

 

 

 

原始出处:

Sunyoung Lee. Et al. Visceral Adiposity as a Risk Factor for Lean Nonalcoholic Fatty Liver Disease in Potential Living Liver Donors.  Journal of Gastroenterology and Hepatology.2021.

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