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通过瞬时弹性成像测量肝脏硬度和控制衰减参数筛查脂肪肝疾病的潜在影响:一项试点研究。

Potential impact of screening for fatty liver disease by transient elastography with liver stiffness and controlled attenuation parameter measurements: a pilot study.

作者信息

Peiseler Moritz, Creutzfeldt Anna, Cassens Insa, Glaubke Claudia, Kroll Claudia, Lohse Ansgar W, Weiler-Normann Christina

出版信息

Z Gastroenterol. 2017 Aug;55(8):754-760. doi: 10.1055/s-0043-111804. Epub 2017 Jun 27.

Abstract

The prevalence of chronic liver diseases is high in developed countries, and the leading causes are amenable to prevention. The German Lebertag is to increase awareness of the burden of chronic liver diseases in the general public. We performed a pilot study using transient elastography with liver stiffness measurement (LSM) and the controlled attenuation parameter (CAP) as a screening tool for previously unrecognized liver diseases.  LSM and CAP was performed in 60 individuals, and participants filled in a questionnaire reporting basic characteristics and past medical history.  Median LSM and CAP values were within the normal range. Participants with self-reported diabetes mellitus had significantly elevated LSM (p = 0.02) and CAP values (p = 0.002). Participants with a BMI > 30 kg/m or dyslipidemia had significantly elevated CAP values (p = 0.007 and p = 0.01, respectively) with normal LSM values. Overall, 35 % of participants had elevated CAP values, indicating a high prevalence of hepatic steatosis.  In a German pilot study, diabetes mellitus was a key risk factor for increased LSM and CAP values. Prevalence of steatosis was high and comparable to other Western countries. Transient elastography is a valuable tool to identify patients with increased risk for metabolic liver diseases. In people without risk factors, LSM and CAP values were within the normal range, indicating that screening for chronic liver injury was not warranted.

摘要

在发达国家,慢性肝病的患病率很高,其主要病因是可以预防的。德国肝脏日旨在提高公众对慢性肝病负担的认识。我们进行了一项试点研究,使用瞬时弹性成像技术测量肝脏硬度值(LSM)和受控衰减参数(CAP),作为筛查此前未被识别的肝脏疾病的工具。对60名个体进行了LSM和CAP检测,参与者填写了一份报告基本特征和既往病史的问卷。LSM和CAP的中位数在正常范围内。自我报告患有糖尿病的参与者LSM值(p = 0.02)和CAP值(p = 0.002)显著升高。体重指数(BMI)> 30 kg/m²或患有血脂异常的参与者CAP值显著升高(分别为p = 0.007和p = 0.01),而LSM值正常。总体而言,35%的参与者CAP值升高,表明肝脂肪变性的患病率很高。在一项德国试点研究中,糖尿病是LSM和CAP值升高的关键危险因素。脂肪变性的患病率很高,与其他西方国家相当。瞬时弹性成像是识别代谢性肝病风险增加患者的有价值工具。在没有危险因素的人群中,LSM和CAP值在正常范围内,这表明没有必要对慢性肝损伤进行筛查。

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