日本非酒精性脂肪性肝病的临床病理研究：纤维化的危险因素
Clinicopathological study of nonalcoholic fatty liver disease in Japan: the risk factors for fibrosis.
作者信息
Miyaaki Hisamitsu, Ichikawa Tatsuki, Nakao Kazuhiko, Yatsuhashi Hiroshi, Furukawa Ryuji, Ohba Kazuo, Omagari Katsuhisa, Kusumoto Yukio, Yanagi Kenji, Inoue Osami, Kinoshita Noboru, Ishibashi Hiromi, Yano Michitami, Eguchi Katsumi
机构信息
The First Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto, Nagasaki, Japan.
出版信息
Liver Int. 2008 Apr;28(4):519-24. doi: 10.1111/j.1478-3231.2007.01614.x. Epub 2007 Nov 1.
BACKGROUND/AIMS: We evaluated patients with nonalcoholic fatty liver disease (NAFLD) and compared the clinical and pathological features to identify the risk factors for NAFLD with severe fibrosis.
METHODS
One hundred and eighty-two patients with biopsy-confirmed NAFLD from various medical centres were recruited into this study.
RESULTS
The variables that were significantly associated with severe steatosis were male gender (mild:severe=36%:53%, P=0.02), younger age (mild:severe=57%:82%, P>0.001) and absence of type 2 diabetes (mild:severe=43%:71%, P>0.001). There was no significant difference in the degree of inflammation among the clinical groups. The variables that were significantly associated with severe fibrosis were female gender (mild:severe=54%:84%, P=0.002), older age (> or = 60 years old) (mild:severe=29%:53%, P=0.020), type 2 diabetes (mild:severe=42%:71%, P=0.020) and hypertension (mild:severe=24%:53%, P=0.002). Although there were more obese patients in the group with severe fibrosis, the association was not statistically significant (mild:severe=67%:78%, P=0.229). The prevalence of high serum triglyceride levels was similar between the two groups. The N (Nippon) score (total number of risk factor) could significantly predict severe fibrosis in NAFLD patients (1.48 +/- 1.14 vs. 2.66 +/- 0.94, P<0.001).
CONCLUSIONS
The N score can be used to predict severe fibrosis in cases of NAFLD.
背景/目的：我们对非酒精性脂肪性肝病（NAFLD）患者进行了评估，并比较了其临床和病理特征，以确定NAFLD合并严重纤维化的危险因素。
方法
本研究纳入了来自不同医疗中心的182例经活检确诊为NAFLD的患者。
结果
与严重脂肪变性显著相关的变量包括男性（轻度：重度=36%：53%，P=0.02）、较年轻的年龄（轻度：重度=57%：82%，P>0.001）以及无2型糖尿病（轻度：重度=43%：71%，P>0.001）。各临床组之间的炎症程度无显著差异。与严重纤维化显著相关的变量包括女性（轻度：重度=54%：84%，P=0.002）、年龄较大（≥60岁）（轻度：重度=29%：53%，P=0.020）、2型糖尿病（轻度：重度=42%：71%，P=0.020）和高血压（轻度：重度=24%：53%，P=0.002）。尽管严重纤维化组中肥胖患者更多，但这种关联无统计学意义（轻度：重度=67%：78%，P=0.229）。两组之间高血清甘油三酯水平的患病率相似。N（日本）评分（危险因素总数）可显著预测NAFLD患者的严重纤维化（1.48±1.14对2.66±0.94，P<0.001）。
结论
N评分可用于预测NAFLD患者的严重纤维化。
Zotero 插件