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维生素E对伴有代谢综合征的非酒精性脂肪性肝病的影响:一项倾向评分匹配队列研究。

Effect of vitamin E in nonalcoholic fatty liver disease with metabolic syndrome: A propensity score-matched cohort study.

作者信息

Kim Gi Hyun, Chung Jung Wha, Lee Jong Ho, Ok Kyeong Sam, Jang Eun Sun, Kim Jaihwan, Shin Cheol Min, Park Young Soo, Hwang Jin-Hyeok, Jeong Sook-Hyang, Kim Nayoung, Lee Dong Ho, Kim Jin-Wook

机构信息

Department of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Clin Mol Hepatol. 2015 Dec;21(4):379-86. doi: 10.3350/cmh.2015.21.4.379. Epub 2015 Dec 24.

Abstract

BACKGROUND/AIMS: Vitamin E improves the biochemical profiles and liver histology in nonalcoholic steatohepatitis, but the role of vitamin E is not clearly defined in the management of nonalcoholic fatty liver disease (NAFLD) which includes both simple steatosis and steatohepatitis. Co-morbid metabolic syndrome increases the probability of steatohepatitis in NAFLD. In this study, we aimed to determine the short-term effects of vitamin E and off-treatment durability of response in a propensity-score matched cohort of NAFLD patients with metabolic syndrome.

METHODS

A retrospective cohort was constructed by retrieving 526 consecutive NAFLD patients from the electronic medical record data warehouse of a tertiary referral hospital in South Korea. Among them, 335 patients (63.7%) had metabolic syndrome and were eligible for vitamin E therapy. In order to assess the effect of vitamin E, propensity score matching was used by matching covariates between control patients (n=250) and patients who received vitamin E (n=85).

RESULTS

The PS-matched vitamin E group (n=58) and control group (n=58) exhibited similar baseline metabolic profiles. After 6 months of vitamin E therapy, the mean ALT levels decreased significantly compared to PS-matched control (P<0.01). The changes in metabolic profiles (body weight, lipid and glucose levels) did not differ between control and vitamin E groups during the study period.

CONCLUSIONS

Short-term vitamin E treatment significantly reduces ALT levels in NAFLD patients with metabolic syndrome, but metabolic profiles are not affected by vitamin E.

摘要

背景/目的:维生素E可改善非酒精性脂肪性肝炎的生化指标和肝脏组织学,但在包括单纯性脂肪变性和脂肪性肝炎的非酒精性脂肪性肝病(NAFLD)管理中,维生素E的作用尚未明确界定。合并代谢综合征会增加NAFLD患者发生脂肪性肝炎的概率。在本研究中,我们旨在确定维生素E对患有代谢综合征的NAFLD患者倾向评分匹配队列的短期影响以及停药后反应的持续性。

方法

通过从韩国一家三级转诊医院的电子病历数据仓库中检索526例连续的NAFLD患者构建回顾性队列。其中,335例患者(63.7%)患有代谢综合征,符合维生素E治疗条件。为评估维生素E的效果,通过匹配对照组患者(n = 250)和接受维生素E治疗的患者(n = 85)之间的协变量进行倾向评分匹配。

结果

倾向评分匹配的维生素E组(n = 58)和对照组(n = 58)表现出相似的基线代谢特征。维生素E治疗6个月后,与倾向评分匹配的对照组相比,平均ALT水平显著降低(P < 0.01)。在研究期间,对照组和维生素E组之间的代谢特征(体重、脂质和血糖水平)变化无差异。

结论

短期维生素E治疗可显著降低患有代谢综合征的NAFLD患者的ALT水平,但代谢特征不受维生素E影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bc1/4712166/f4e00d07fe98/cmh-21-379-g001.jpg

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