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非酒精性脂肪性肝病中体重指数和血清参数与脂肪变超声分级的相关性

Correlation of Body Mass Index and Serum Parameters With Ultrasonographic Grade of Fatty Change in Non-alcoholic Fatty Liver Disease.

作者信息

Abangah Ghobad, Yousefi Atefeh, Asadollahi Rouhangiz, Veisani Yousef, Rahimifar Paria, Alizadeh Sajjad

机构信息

Department of Gastroenterology and Hepatology, Ilam University of Medical Sciences, Ilam, IR Iran.

Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran.

出版信息

Iran Red Crescent Med J. 2014 Jan;16(1):e12669. doi: 10.5812/ircmj.12669. Epub 2014 Jan 5.

Abstract

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is a common liver disease in the western population and expanding disease in the world. Pathological changes in fatty liver are like alcohol liver damage, which can lead to end-stage liver disease. The prevalence of NAFLD in obese or overweight people is higher than general population, and it seems that people with high Body Mass Index (BMI) or abnormality in some laboratory tests are more susceptible for severe fatty liver and high grade of NAFLD in ultrasonography (U.S).

OBJECTIVES

This study aimed to evaluate the correlation of BMI and laboratory tests with NAFLD in ultrasonography.

MATERIALS AND METHODS

During a multi-step process, we selected two-hundred and thirteen cases from four hundred and eighteen patients with NAFLD. Laboratory tests performed included: ALT, AST, FBS, Triglyceride and cholesterol levels, hepatitis B surface antigen, hepatitis C antibody, ceruloplasmin, serum iron, TIBC, transferrin saturation, ferritin, AMA, ANA, ANTI LKM1, serum protein electrophoresis, TSH, anti TTG (IgA). BMI and ultrasonography for 213 patients were performed, and then data was analyzed. These parameters and grades of ultrasonography were compared with the values obtained using one way ANOVA. An ordinal logistic regression model was used to estimate the probability of ultrasonography grade. The Statistical Package for the Social Science program (SPSS, version 16.0) was used for data analysis.

RESULTS

Two-hundred and thirteen cases including 140 male and 73 female, were studied. In general, 72.3% of patients were overweight and obese. Post-hoc tests showed that only BMI (P < 0.001) and TG (P < 0.011) among variables had statistically significant associations with ultrasonography grade (USG), and ordinal logistic regression model showed that BMI and AST were the best predictors.

DISCUSSION

Our results suggest that in patients with NAFLD, BMI and TG are most effective factors in severity of fatty liver disease and ultrasonography grade (USG). On the other hand, BMI as a predictor can be helpful. But, AST has not been a reliable finding, because it changes in many conditions.

摘要

背景

非酒精性脂肪性肝病(NAFLD)是西方人群中常见的肝脏疾病,且在全球范围内呈扩大趋势。脂肪肝的病理变化类似于酒精性肝损伤,可导致终末期肝病。肥胖或超重人群中NAFLD的患病率高于普通人群,似乎体重指数(BMI)高或某些实验室检查异常的人更容易发生严重脂肪肝,且超声检查(U.S)显示NAFLD的分级更高。

目的

本研究旨在评估BMI和实验室检查与超声检查中NAFLD的相关性。

材料与方法

在一个多步骤过程中,我们从418例NAFLD患者中选取了213例。进行的实验室检查包括:谷丙转氨酶(ALT)、谷草转氨酶(AST)、空腹血糖(FBS)、甘油三酯和胆固醇水平、乙肝表面抗原、丙肝抗体、铜蓝蛋白、血清铁、总铁结合力(TIBC)、转铁蛋白饱和度、铁蛋白、抗线粒体抗体(AMA)、抗核抗体(ANA)、抗肝肾微粒体抗体1(ANTI LKM1)、血清蛋白电泳、促甲状腺激素(TSH)、抗组织转谷氨酰胺酶(抗TTG,IgA)。对213例患者进行了BMI和超声检查,然后对数据进行分析。将这些参数和超声检查分级与使用单因素方差分析获得的值进行比较。使用有序逻辑回归模型估计超声检查分级的概率。使用社会科学统计软件包程序(SPSS,版本16.0)进行数据分析。

结果

研究了213例病例,其中男性140例,女性73例。总体而言,72.3%的患者超重和肥胖。事后检验显示,变量中只有BMI(P < 0.001)和甘油三酯(TG,P < 0.011)与超声检查分级(USG)有统计学显著关联,有序逻辑回归模型显示BMI和AST是最佳预测指标。

讨论

我们的结果表明,在NAFLD患者中,BMI和TG是脂肪肝疾病严重程度和超声检查分级(USG)的最有效因素。另一方面,BMI作为预测指标可能会有所帮助。但是,AST并不是一个可靠的指标,因为它在许多情况下都会发生变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c1b/3964422/7f49ae0ae396/ircmj-16-12669-i001.jpg

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