内脏脂肪与酒精性/纳醇性脂肪性肝炎相关肝硬化患者复发性食管静脉曲张恶化有关

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Journal of Nippon Medical School Pub Date : 2024-01-01 DOI:10.1272/jnms.JNMS.2024_91-405
Ryohei Nishiguchi, Yoshihiro Furuichi, Takeshi Shimakawa, Shinichi Asaka, Kentaro Yamaguchi, Yukio Shimojima, Teppei Kono, Sachiyo Okayama, Rieko Shimojima, Masano Sagawa, Kotaro Kuhara, Takebumi Usui, Hajime Yokomizo, Seiji Ohigashi, Koichiro Sato, Hiroyuki Kato, Shunichi Shiozawa
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引用次数: 0

摘要

背景:酒精性脂肪性肝炎和非酒精性脂肪性肝炎相关肝硬化(ASH/NASH-LC)是食管静脉曲张(EVs)的主要病因。然而,高内脏脂肪与食管静脉曲张恶化之间的关系仍不清楚。本研究旨在明确内脏脂肪与 ASH/NASH-LC 中 EVs 复发率的关系,并确定与复发相关的独立预测因素:我们回顾性评估了94例接受内窥镜注射硬化剂治疗EVs的ASH/NASH-LC患者的数据。利用内脏脂肪指数(VFI;46.4 cm2/m2)临界值的接收者操作特征曲线,我们将患者分为高VFI(n = 53)和低VFI(n = 41)两类。我们采用倾向评分匹配法来调整背景因素,并比较了两组患者的 EV 复发率。通过多变量分析确定了与食管静脉曲张复发相关的预测因素。此外,还调查了病毒性食管静脉曲张患者的复发率:在总体分析中,高 VFI 组的复发率明显高于低 VFI 组(P = 0.023)。在倾向评分匹配后,高 VFI 组的复发率也高于低 VFI 组,每组有 19 名患者进行了匹配(P = 0.048)。VFI和Child-Pugh评分与复发独立相关。两组病毒性 LC 患者的复发率相当:结论:在 ASH/NASH-LC 中观察到高内脏脂肪患者的静脉曲张复发情况恶化,但在病毒性 LC 中未观察到。此外,高内脏脂肪是静脉曲张复发的一个独立预测因素。
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Visceral Fat Associated with Worsening of Recurrent Esophageal Varices in Alcoholic/Nonalcoholic Steatohepatitis-Related Liver Cirrhosis.

Background: Alcoholic steatohepatitis and nonalcoholic steatohepatitis-related liver cirrhosis (ASH/NASH-LC) are major causes of esophageal varices (EVs). However, the association between high visceral fat and exacerbation of EVs remains unclear. The aim of this study was to clarify the association of visceral fat and recurrence rate of EVs in ASH/NASH-LC and to identify independent predictors associated with recurrence.

Methods: We retrospectively evaluated data from 94 patients who underwent endoscopic injection sclerotherapy for EVs with ASH/NASH-LC. Using the receiver operating characteristic curve for the cut-off value of visceral fat index (VFI; 46.4 cm2/m2), we classified patients as having a high VFI (n = 53) or low VFI (n = 41). Propensity score matching was used to align for background factors, and the recurrence rate of EVs was compared between the two groups. Predictors associated with esophageal variceal recurrence were identified by multivariate analysis. The recurrence rate in patients with viral LC was also investigated.

Results: In the overall analysis, the recurrence rate was significantly higher in the high VFI group than in the low VFI group (P = 0.023). The recurrence rate was also higher in the high VFI group than in the low VFI group after propensity score matching, in which 19 patients were matched in each group (P = 0.048). VFI and Child-Pugh score were independently associated with recurrence. Recurrence rates were comparable between the two groups in viral LC patients.

Conclusions: Worsening of variceal recurrence was observed in high visceral fat patients in ASH/NASH-LC but not in viral LC. Furthermore, high visceral fat was an independent predictor associated with variceal recurrence.

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来源期刊
Journal of Nippon Medical School
Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-
CiteScore
1.80
自引率
10.00%
发文量
118
期刊介绍: The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.
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