Leite Andrea Benevides, Mattos Angelo Alves de, Mattos Angelo Zambam de, Coral Gabriela Perdomo, Evaldt Sandro
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
Arq Gastroenterol. 2012 Dec;49(4):245-9. doi: 10.1590/s0004-28032012000400003.
In about 10% of patients with chronic liver disease, it is not possible to identify an etiologic factor. These cases are called cryptogenic cirrhosis. Currently, nonalcoholic steatohepatitis (NASH) is being considered as a possible etiologic factor for a significant segment of patients that presents with cryptogenic cirrhosis.
To estimate the prevalence of risk factors for NASH in patients with cryptogenic cirrhosis, in order to verify if there is a causal relationship between them.
Cross-sectional study, with evaluation of the demographic and laboratorial data of patients with cryptogenic cirrhosis. They were compared with data obtained from a group with NASH and a group with alcoholic and/or hepatitis C (HCV) cirrhosis.
Forty seven patients with cryptogenic cirrhosis were evaluated, 47 with NASH and 196 with HCV and/or alcoholic cirrhosis. The mean age of patients with cryptogenic cirrhosis was 52 years, while in those with NASH it was 46.4 years (P = 0,041). The group with cryptogenic cirrhosis had 23 female and 24 male patients. Of the patients who presented with NASH, 68.1% were female. Of the patients who presented with alcoholic/HCV cirrhosis, 64.8% were male. There were no statistically significant differences between the groups. In cryptogenic cirrhosis patients, the following prevalences could be observed: impaired fasting glycemia - 68.2%; obesity - 27.5%; total hypercholesterolemia - 27.9%; low HDL levels - 58.1% (women - 81%; men - 36.4%); hypertriglyceridemia - 16.3%. The results seen in cryptogenic cirrhosis patients showed statistical similarity with the results of the NASH group regarding fasting glycemia (62.8%) and male HDL levels (53.8%). The comparison with the alcoholic/HCV cirrhosis group showed statistical differences regarding fasting glycemia (45.2%), hypercholesterolemia (13.3%) and female HDL levels (50.8%).
It is not possible to establish a causal relationship between cryptogenic cirrhosis and NASH. Only data related to fasting glycemia and HDL levels in male patients showed statistical similarities between both groups of patients.
在约10%的慢性肝病患者中，无法确定病因。这些病例被称为隐源性肝硬化。目前，非酒精性脂肪性肝炎（NASH）被认为是隐源性肝硬化患者中相当一部分人的可能病因。
评估隐源性肝硬化患者中NASH危险因素的患病率，以验证它们之间是否存在因果关系。
横断面研究，评估隐源性肝硬化患者的人口统计学和实验室数据。将他们与从NASH组以及酒精性和/或丙型肝炎（HCV）肝硬化组获得的数据进行比较。
评估了47例隐源性肝硬化患者、47例NASH患者和196例HCV和/或酒精性肝硬化患者。隐源性肝硬化患者的平均年龄为52岁，而NASH患者的平均年龄为46.4岁（P = 0.041）。隐源性肝硬化组有23名女性和24名男性患者。在NASH患者中，68.1%为女性。在酒精性/HCV肝硬化患者中，64.8%为男性。各组之间无统计学显著差异。在隐源性肝硬化患者中，可观察到以下患病率：空腹血糖受损 - 68.2%；肥胖 - 27.5%；总胆固醇血症 - 27.9%；高密度脂蛋白（HDL）水平低 - 58.1%（女性 - 81%；男性 - 36.4%）；高甘油三酯血症 - 16.3%。隐源性肝硬化患者的结果在空腹血糖（62.8%）和男性HDL水平（53.8%）方面与NASH组的结果显示出统计学相似性。与酒精性/HCV肝硬化组的比较显示，在空腹血糖（45.2%）、高胆固醇血症（13.3%）和女性HDL水平（50.8%）方面存在统计学差异。
无法在隐源性肝硬化和NASH之间建立因果关系。仅男性患者中与空腹血糖和HDL水平相关的数据在两组患者之间显示出统计学相似性。
