[基于临床特征的非酒精性脂肪肝与代谢功能障碍相关性脂肪肝差异分析]。

Y X Liu, F Guo, L N Niu, B Zhang, J Dou, Q Xu, Z H Ning, X Z Wang
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引用次数: 0

摘要

目的探讨脂肪肝(FLD)从非酒精性脂肪肝(NAFLD)到代谢功能障碍相关性脂肪肝(MASLD)的临床特征,从而阐明三种更名下的临床应用价值。研究方法选取2020年1月至2023年9月在新疆医科大学附属中医医院肝病科住院治疗,诊断为非酒精性脂肪肝(NAFLD)、代谢相关性脂肪肝(MAFLD)或代谢相关性脂肪肝(MASLD)的患者为研究对象。比较三组患者的临床指标差异,主要包括一般资料(年龄、性别、体重指数、既往史等)、血清学指标(肝肾功能、血脂、血糖、凝血功能等)、无创肝纤维化指标、脂肪衰减参数等。测量数据采用方差分析和秩和检验,计数数据采用χ(2)检验。结果在 536 例患者中,非酒精性脂肪肝、脂肪肝 MAFLD 和脂肪肝 MASLD 的患病率分别为 64.0%、93.7% 和 100%。其中有 318 例(59.3%)同时符合三种脂肪肝名称。NAFLD、MAFLD和MASLD中男性比例分别为30.9%、55.8%和53.9%。饮酒史比例分别为 0、36.7% 和 36.0%。吸烟史比例分别为 7.0%、31.9% 和 30.6%。体重指数分别为(27.66 ± 3.97)、(28.33 ± 3.63)和(27.90 ± 3.89)kg/m(2)。γ-谷氨酰转移酶水平分别为 26.6(18.0,47.0)U/L、31.0(20.0,53.0)U/L 和 30.8(19.8,30.8)U/L。高密度脂蛋白胆固醇水平分别为 1.07(0.90,1.23)毫摩尔/升、1.02(0.86,1.19)毫摩尔/升和 1.03(0.87,1.21)毫摩尔/升。顺序测量的尿酸分别为(322.98 ± 84.51)μmol/L、(346.57 ± 89.49)μmol/L和(344.89 ± 89.67)μmol/L。顺序测量的肌酐分别为 69.6(62.9,79.0)μmol/L、73.0(65.0,83.5)μmol/L 和 73.0(65.0,83.0)μmol/L。肥胖比例的连续分析结果分别为 74.3%、81.7% 和 76.5%,差异有统计学意义(PC 结论:与非酒精性脂肪肝人群相比,非酒精性脂肪肝患者的肥胖比例较高:与非酒精性脂肪肝人群相比,MAFLD和MASLD人群主要为男性、肥胖、有吸烟和饮酒史。γ-谷氨酰转移酶、尿酸和肌酐水平略高,而高密度脂蛋白胆固醇水平较低。MASLD在非酒精性脂肪肝和酒精性脂肪肝中的出现是以遗传和进展为基础的,这再次强调了代谢因素在脂肪肝中的重要作用。
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[Analysis of non-alcoholic fatty liver disease differences from metabolic dysfunction-associated fatty liver disease based on clinical features].

Objective: To explore the clinical features of fatty liver disease (FLD) from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MASLD), so as to elucidate its clinical application value under three renames. Methods: Patients who were hospitalized in the Department of Hepatology, Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, from January 2020 to September 2023 and met the diagnosis of NAFLD, metabolic-associated fatty liver disease (MAFLD), or MASLD were selected as the research subjects. The clinical indicators differences among the three groups of patients were compared, mainly including general information (age, gender, body mass index, past history, etc.), serological indicators (liver and kidney function, blood lipids, blood sugar, coagulation function, etc.), non-invasive liver fibrosis indicators, fat attenuation parameters, etc. Measurement data were analyzed using ANOVA and the rank sum test, while count data were analyzed using the χ(2) test. Results: NAFLD, MAFLD, and MASLD prevalence rates among 536 cases were 64.0%, 93.7%, and 100%, respectively. 318 cases (59.3%) met the three fatty liver names at the same time among them. Male population proportions in NAFLD, MAFLD, and MASLD were 30.9%, 55.8%, and 53.9%, respectively. The alcohol consumption history proportion was 0, 36.7%, and 36.0%, respectively. The smoking history proportion was 7.0%, 31.9%, and 30.6%, respectively. The body mass index was (27.66 ± 3.97), (28.33 ± 3.63), and (27.90 ± 3.89) kg/m(2), respectively. The γ-glutamyltransferase levels were 26.6 (18.0, 47.0) U/L, 31.0 (20.0, 53.0) U/L, and 30.8 (19.8, 30.8) U/L, respectively. The high-density lipoprotein cholesterol levels were 1.07 (0.90, 1.23) mmol/L, 1.02 (0.86, 1.19) mmol/L, and 1.03 (0.87,1.21) mmol/L, respectively. Sequentially measured uric acid was (322.98 ± 84.51) μmol/L, (346.57 ± 89.49) μmol/L, and (344.89 ±89.67) μmol/L, respectively. Sequentially measured creatinine was 69.6 (62.9, 79.0) μmol/L, 73.0 (65.0, 83.5) μmol/L, and 73.0 (65.0, 83.0) μmol/L, respectively. The sequential analysis of obesity proportion was 74.3%, 81.7%, and 76.5%, respectively, with statistically significant differences (P<0.05). Conclusion: Compared with the NAFLD population, the MAFLD and MASLD populations were predominantly male, obese, and had a history of smoking and drinking. The levels of γ-glutamyltransferase, uric acid, and creatinine were slightly higher, while the levels of high-density lipoprotein cholesterol were lower. MASLD appeared in NAFLD and MAFLD on the basis of inheritance and progression, emphasizing once again the important role of metabolic factors in a fatty liver.

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来源期刊
中华肝脏病杂志
中华肝脏病杂志 Medicine-Medicine (all)
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7574
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