JGH:肝纤维化和脂肪肝与心血管疾病风险独立相关

2021-06-23 MedSci原创 MedSci原创

最新研究显示重度肝纤维化是非酒精性脂肪性肝病(NAFLD)患者死亡的重要预测因素,尤其是心血管事件导致的死亡。

      最新研究显示重度肝纤维化是非酒精性脂肪性肝病(NAFLD)患者死亡的重要预测因素,尤其是血管事件导致的死亡。含糖饮料和缺乏运动很大程度上促使肥胖呈上升趋势,并没有放缓的迹象。研究显示美国的肥胖人群在过去的25年成倍增长。NAFLD发生率随着肥胖比例骤增,并成为美国最普遍的肝脏疾病。NAFLD是一组慢性肝脏疾病,包括不伴有纤维化的肝脏脂肪变性、伴有纤维化的非酒精性脂肪性肝炎(NASH)以及肝硬化。肝纤维化、脂肪肝和心血管疾病 (CVD) 风险之间的关联尚不清楚。因此,本研究旨在探究肝纤维化和脂肪肝与 CVD 风险之间的关联。

 

      研究人员进行了一项前瞻性研究。肝纤维化通过血清纤维化标志物进行评估,包括 FIB-4、非酒精性脂肪性肝病纤维化评分 (NFS) 和紫藤凝集素阳性 Mac-2 结合蛋白 (WFA + -M2BP)检测,而脂肪肝通过超声检查诊断。使用弗雷明汉风险评分 (FRS) 评估 CVD 风险,高 CVD 风险定义为 FRS ≥ 20%。

 

      本项研究共招募了 3512 名受试者,其中 17.5% 的受试者具有高 CVD 风险(FRS ≥ 20%)。晚期纤维化(FIB-4 ≥ 2.67,NFS ≥ 0.675,WFA + -M2BP ≥ 1.0)和脂肪肝的存在与高 CVD 风险显着相关,与糖尿病、血脂异常和高血压无关。当受试者按肝纤维化和脂肪肝分层时,晚期纤维化和脂肪肝受试者具有最高的 CVD 风险(优势比 [OR]:5.90-35.6),其次是晚期纤维化且无脂肪肝的受试者(OR : 2.53–9.62) 。

 

      本项研究通过人群分析证实肝纤维化和脂肪肝与 CVD 风险相关,与已知的 CVD 风险合并症无关。肝纤维化和脂肪肝的评估可能有助于识别高 CVD 风险的患者。

 

 

原始出处:

Nobuharu Tamaki. Et al. Liver fibrosis and fatty liver are independently associated with cardiovascular disease risk.  J Gastroenterology H.2021.

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    2021-06-27 1453df99m58暂无昵称

    重度肝纤维化是非酒精性脂肪性肝病(NAFLD)患者死亡的重要预测因素。

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