生活方式相关疾病和年龄对非酒精性脂肪性肝病的发生和进展的影响。

Influence of lifestyle-related diseases and age on the development and progression of non-alcoholic fatty liver disease.

机构信息

Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan.

出版信息

Hepatol Res. 2015 May;45(5):548-59. doi: 10.1111/hepr.12384. Epub 2014 Aug 13.

DOI:10.1111/hepr.12384

PMID:24976563

Abstract

AIM

Although non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome, the clinical association between non-alcoholic steatohepatitis (NASH) and lifestyle-related diseases such as obesity, type 2 diabetes mellitus (DM), hypertension (HT) and dyslipidemia (DL) has not been clarified. We studied the influence of lifestyle-related diseases and age on the development and progression of NAFLD.

METHODS

We enrolled 550 patients with biopsy-proven NAFLD (284 men, 266 women; average age, 52 and 62 years, respectively). The effect of lifestyle-related diseases and age (≤49 vs ≥50 years) on the frequency of NASH and advanced fibrosis (≥stage 3) was studied.

RESULTS

Prevalence of obesity, DM, HT and DL in male and female NASH patients was 75%/67%, 53%/54%, 66%/77% and 85/79%, respectively. DM patients had a higher frequency of NASH in the older male NAFLD group and a higher frequency of advanced fibrosis in the older female NASH group. With the increasing number of complicating lifestyle-related diseases, the rate of NASH increased in male NAFLD patients. In both sexes, aging resulted in the development of NASH and progression of liver fibrosis. Multivariate logistic regression analysis revealed that age and DM were significantly associated with the development of NASH in male NAFLD patients and progression of fibrosis in female NASH patients.

CONCLUSION

Age is strongly associated with the development and progression of NASH. Type 2 DM may play the most crucial role among lifestyle-related diseases in the development and progression of NASH.

摘要

目的

非酒精性脂肪性肝病（NAFLD）是代谢综合征的肝脏表现，但非酒精性脂肪性肝炎（NASH）与肥胖症、2 型糖尿病（DM）、高血压（HT）和血脂异常（DL）等与生活方式相关的疾病之间的临床关联尚未阐明。我们研究了与生活方式相关的疾病和年龄对 NAFLD 发生和进展的影响。

方法

我们纳入了 550 例经活检证实的 NAFLD 患者（男性 284 例，女性 266 例；平均年龄分别为 52 岁和 62 岁）。研究了与生活方式相关的疾病和年龄（≤49 岁与≥50 岁）对 NASH 和高级纤维化（≥3 期）发生率的影响。

结果

男性和女性 NASH 患者中肥胖症、DM、HT 和 DL 的患病率分别为 75%/67%、53%/54%、66%/77%和 85/79%。老年男性 NAFLD 组中 DM 患者 NASH 发生率较高，老年女性 NASH 组中 DM 患者高级纤维化发生率较高。随着合并的生活方式相关疾病数量的增加，男性 NAFLD 患者 NASH 的发生率增加。在两性中，年龄增长导致 NASH 的发生和肝纤维化的进展。多变量逻辑回归分析显示，年龄和 DM 与男性 NAFLD 患者 NASH 的发生以及女性 NASH 患者纤维化的进展显著相关。