代谢健康比肥胖在非酒精性脂肪性肝病发展中更为重要：一项 4 年回顾性研究。

Metabolic Health Is More Important than Obesity in the Development of Nonalcoholic Fatty Liver Disease: A 4-Year Retrospective Study.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Endocrinol Metab (Seoul). 2015 Dec;30(4):522-30. doi: 10.3803/EnM.2015.30.4.522. Epub 2015 Sep 22.

DOI:10.3803/EnM.2015.30.4.522

PMID:26394730

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4722408/

Abstract

BACKGROUND

The aim of this study is to compare the risk for future development of nonalcoholic fatty liver disease (NAFLD) according to different status of metabolic health and obesity.

METHODS

A total of 3,045 subjects without NAFLD and diabetes at baseline were followed for 4 years. Subjects were categorized into four groups according to the following baseline metabolic health and obesity statuses: metabolically healthy, non-obese (MHNO); metabolically healthy, obese (MHO); metabolically unhealthy, non-obese (MUHNO); and metabolically unhealthy, obese (MUHO). Being metabolically healthy was defined as having fewer than two of the following five components: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostasis model assessment-insulin resistance index. Obesity was defined as a body mass index >25 kg/m². The presence of NAFLD was assessed by ultrasonography.

RESULTS

The proportions of subjects included in the MHNO, MHO, MUHNO, and MUHO groups were 71.4%, 9.8%, 13.0%, and 5.8%, respectively. The proportions of subjects who developed NAFLD were 10.5%, 31.4%, 23.2%, and 42% in the MHNO, MHO, MUHNO, and MUHO groups, respectively. The risk for developing NAFLD was highest in subjects who were metabolically unhealthy both at baseline and after 4 years compared with subjects who were consistently metabolically healthy during the follow-up period (odds ratio, 2.862). Using the MHNO group as reference, the odds ratios for the MHO, MUHNO, and MUHO groups were 1.731, 1.877, and 2.501, respectively.

CONCLUSION

The risk for NAFLD was lower in MHO subjects than in MUNO subjects.

摘要

背景

本研究旨在比较不同代谢健康和肥胖状态下非酒精性脂肪性肝病（NAFLD）未来发展的风险。

方法

共有 3045 名基线时无 NAFLD 和糖尿病的受试者随访 4 年。根据以下基线代谢健康和肥胖状态，将受试者分为四组：代谢健康、非肥胖（MHNO）；代谢健康、肥胖（MHO）；代谢不健康、非肥胖（MUHNO）；代谢不健康、肥胖（MUHO）。代谢健康定义为以下五个成分中少于两个：高血压、空腹血糖高、甘油三酯高、高密度脂蛋白胆固醇低和胰岛素抵抗指数最高十分位数。肥胖定义为体重指数>25 kg/m²。通过超声评估 NAFLD 的存在。

结果

MHNO、MHO、MUHNO 和 MUHO 组的受试者比例分别为 71.4%、9.8%、13.0%和 5.8%。MHNO、MHO、MUHNO 和 MUHO 组中分别有 10.5%、31.4%、23.2%和 42%的受试者发展为 NAFLD。与整个随访期间持续代谢健康的受试者相比，基线和 4 年后代谢均不健康的受试者发生 NAFLD 的风险最高（比值比，2.862）。以 MHNO 组为参照，MHO、MUHNO 和 MUHO 组的比值比分别为 1.731、1.877 和 2.501。