Penn State Hershey Medical Center, Department of Medicine, Hershey, PO Box 850;MC045 Hershey, PA 17033, USA.
J Gastrointestin Liver Dis. 2009 Sep;18(3):299-302.
To evaluate weight history in chronic liver disease and assess for associations with advanced fibrosis. Weight and Lifestyle Inventory (WALI) was used to assess lifelong weight and eating habits.
38 patients had a diagnosis of nonalcoholic fatty liver disease (NAFLD) and 37 had other chronic liver disease. The body mass index (BMI) did not predict the presence of advanced fibrosis. The time with BMI over 30 kg/m2 was 19.2 years+/-15.7 with advanced fibrosis and 8.6 years+/-10.4 in the non-advanced group (p=0.002). Independent predictors of fibrosis were: 1) Non-NAFLD (OR 6.2); 2) obesity, with a BMI over 30 for more than 15 years (OR 12.4); 3) at least moderate alcohol use (OR 12.2); 4) advanced age (OR 3.3). Weight history did not impact NALFD differently from Non-NAFLD.
BMI over 30 for more than 15 years increases the risk of advanced fibrosis in all chronic liver diseases, on par with the risk of alcohol ingestion.
评估慢性肝病患者的体重史，并评估其与晚期纤维化的关系。使用体重和生活方式量表（WALI）评估终生体重和饮食习惯。
38 例患者被诊断为非酒精性脂肪性肝病（NAFLD），37 例患者患有其他慢性肝病。体重指数（BMI）不能预测晚期纤维化的存在。BMI 超过 30 kg/m2 的时间在有晚期纤维化的患者中为 19.2 年+/-15.7，在非晚期纤维化组中为 8.6 年+/-10.4（p=0.002）。纤维化的独立预测因素为：1）非 NAFLD（OR 6.2）；2）肥胖，BMI 超过 30 且持续时间超过 15 年（OR 12.4）；3）至少中度饮酒（OR 12.2）；4）年龄较大（OR 3.3）。体重史对 NAFLD 和非 NAFLD 的影响没有差异。
BMI 超过 30 且持续时间超过 15 年会增加所有慢性肝病患者发生晚期纤维化的风险，与饮酒摄入的风险相当。
