Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China.
Clin Gastroenterol Hepatol. 2013 Mar;11(3):295-302.e1-3. doi: 10.1016/j.cgh.2012.09.025. Epub 2012 Sep 27.
BACKGROUND & AIMS: We investigated the association between anthropometric parameters and results of liver stiffness measurements (LSMs) by transient elastography in healthy subjects and patients with nonalcoholic fatty liver disease (NAFLD).
We analyzed anthropometric and LSM data from 658 healthy subjects (37% male; mean age, 47 ± 11 years; body mass index [BMI], 21.8 ± 3.0 kg/m(2); LSM, 4.4 ± 1.6 kPa) and 247 patients with biopsy-proven NAFLD (50% male; mean age, 48 ± 11 years; BMI, 28.6 ± 6.5 kg/m(2); LSM, 9.6 ± 8.7 kPa). Healthy subjects were defined as individuals without viral hepatitis, alcoholic liver disease, or NAFLD. We investigated associations between anthropometric parameters, including BMI and waist circumference, and LSM.
LSMs were slightly higher among healthy subjects with BMIs ≤ 18.5 kg/m(2) (n = 84, 4.8 ± 1.5 kPa) and BMIs of 25-29.9 kg/m(2) (n = 76, 5.3 ± 2.2 kPa) than those with BMIs of 18.5-24.9 kg/m(2) (n = 492, 4.5 ± 1.9 kPa; P = .16 by analysis of variance). Among patients with NAFLD of Brunt fibrosis stage 0 or 1, LSMs were lowest among those with BMIs of 18.5-24.9 kg/m(2) (stage 0: n = 34, 5.5 ± 2.2 kPa; stage 1: n = 18, 7.2 ± 3.8 kPa). LSMs were higher among those with BMIs of 25-29.9 kg/m(2) (stage 0: n = 41, 6.1 ± 1.3 kPa; stage 1: n = 26, 7.9 ± 3.5 kPa) and highest for those with BMIs ≥30 kg/m(2) (stage 0: n = 13, 8.5 ± 2.2 kPa; stage 1: n = 22, 11.7 ± 5.2 kPa) (P < .001 and P = .002, respectively, by analysis of variance). High BMI was independently associated with high LSM, in addition to fibrosis stage, among patients with NAFLD. Patients with different waist circumferences had comparable LSMs.
BMI ≥30 kg/m(2) is associated with higher LSMs in patients with NAFLD, after adjusting for fibrosis stage.
本研究旨在探讨非酒精性脂肪性肝病（NAFLD）患者和健康人群中，通过瞬时弹性成像检测肝脏硬度时，人体测量参数与结果之间的关系。
我们分析了 658 名健康受试者（37%为男性；平均年龄 47±11 岁；体重指数[BMI]为 21.8±3.0kg/m2；肝脏硬度测量值[LSM]为 4.4±1.6kPa）和 247 名经肝活检证实为 NAFLD 的患者（50%为男性；平均年龄 48±11 岁；BMI 为 28.6±6.5kg/m2；LSM 为 9.6±8.7kPa）的人体测量学和 LSM 数据。健康受试者定义为无病毒性肝炎、酒精性肝病或 NAFLD 的个体。我们研究了 BMI 和腰围等人体测量参数与 LSM 之间的关系。
BMI≤18.5kg/m2（n=84，4.8±1.5kPa）和 BMI 为 25-29.9kg/m2（n=76，5.3±2.2kPa）的健康受试者 LSM 略高于 BMI 为 18.5-24.9kg/m2（n=492，4.5±1.9kPa；方差分析 P=0.16）的健康受试者。在 Brunt 纤维化分期为 0 或 1 的 NAFLD 患者中，BMI 为 18.5-24.9kg/m2 的患者 LSM 最低（分期 0：n=34，5.5±2.2kPa；分期 1：n=18，7.2±3.8kPa）。BMI 为 25-29.9kg/m2 的患者 LSM 较高（分期 0：n=41，6.1±1.3kPa；分期 1：n=26，7.9±3.5kPa），BMI≥30kg/m2 的患者 LSM 最高（分期 0：n=13，8.5±2.2kPa；分期 1：n=22，11.7±5.2kPa）（方差分析 P<0.001 和 P=0.002）。NAFLD 患者中，除纤维化分期外，高 BMI 与高 LSM 独立相关。不同腰围的患者 LSM 无差异。
在调整纤维化分期后，BMI≥30kg/m2 与 NAFLD 患者的高 LSM 相关。
