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菲律宾健康人群中超声检查非酒精性脂肪性肝病严重程度与心脏代谢风险的相关性

Correlation between severity of ultrasonographic nonalcoholic fatty liver disease and cardiometabolic risk among Filipino wellness patients.

作者信息

Cuenza Lucky R, Razon Tamara Louise J, Dayrit Juan Carlo

机构信息

Section of Preventive Cardiology and Cardiac Rehabilitation, Philippine Heart Center, Manila, Philippine.

Department of Radiology, The Medical City Clark, Pampanga, Philippine.

出版信息

J Cardiovasc Thorac Res. 2017;9(2):85-89. doi: 10.15171/jcvtr.2017.14. Epub 2017 Jun 8.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a prevalent condition which is known to be related to factors that predispose to the development of coronary artery disease as well as development of metabolic syndrome. The study aimed to determine the association between ultrasound-based grading of hepatic steatosis with metabolic profile and estimated cardiovascular risk using the Framingham Risk Score (FRS). This was a cross-sectional study on 100 Filipino patients without established cardiovascular disease who underwent a general wellness health evaluation. Cases with NAFLD diagnosed on the basis of ultrasound grading were analyzed. Comparison of demographics and metabolic parameters between grades of hepatic steatosis was performed using Kruskal Wallis test. FRS was used to assess cardiovascular risk with Spearman rank test for correlation with the degree of NAFLD. Mean age was 47 ± 9.6 years, with 70% males. Mean body mass index (BMI) was 28.7 ± 5.1. Most patients had grade I NAFLD (53%), 34% were grade II, and 13% were grade III. BMI ( =0.034), liver enzymes (alanine aminotransferase [ALT], = 0.001; aspartate aminotransferase [AST], = 0.00), triglycerides ( = 0.047), and fasting blood sugar [FBS] ( = 0.049) were associated with fatty liver grade. No association was noted with total cholesterol ( = 0.569), high density lipoprotein (HDL) ( = 0.220), and low density lipoprotein (LDL) ( = 0.792). Using the FRS 43% were stratified as low (<10% risk), 45% as intermediate (10%-20% risk) and 12% as high risk (>20% risk). Severity of fatty liver was directly correlated with the FRS (Spearman rank 0.741, = 0.009). Ultrasound-based grading of the severity of NAFLD is associated with abnormalities in the metabolic profile of patients. The FRS is correlated with increasing severity of NAFLD based on ultrasound. These findings suggest that the presence of NAFLD may be a marker for the presence of increased cardiovascular risk and may help identify patients who may benefit from more aggressive therapies to prevent development of adverse cardiovascular events.

摘要

非酒精性脂肪性肝病(NAFLD)是一种常见病症,已知与易引发冠状动脉疾病以及代谢综合征的因素相关。该研究旨在通过弗明汉风险评分(FRS)确定基于超声的肝脂肪变性分级与代谢状况及估计心血管风险之间的关联。这是一项针对100名未患心血管疾病的菲律宾患者进行的横断面研究,这些患者接受了全面的健康评估。对根据超声分级诊断为NAFLD的病例进行了分析。使用Kruskal Wallis检验对肝脂肪变性各等级之间的人口统计学和代谢参数进行比较。使用FRS评估心血管风险,并采用Spearman秩相关检验分析其与NAFLD程度的相关性。平均年龄为47±9.6岁,男性占70%。平均体重指数(BMI)为28.7±5.1。大多数患者为I级NAFLD(53%),34%为II级,13%为III级。BMI(P = 0.034)、肝酶(丙氨酸氨基转移酶[ALT],P = 0.001;天冬氨酸氨基转移酶[AST],P = 0.00)、甘油三酯(P = 0.047)和空腹血糖[FBS](P = 0.049)与脂肪肝等级相关。总胆固醇(P = 0.569)、高密度脂蛋白(HDL)(P = 0.220)和低密度脂蛋白(LDL)(P = 0.792)与脂肪肝等级无关联。使用FRS进行分层,43%为低风险(<10%风险),45%为中度风险(10%-20%风险),12%为高风险(>20%风险)。脂肪肝严重程度与FRS直接相关(Spearman秩相关系数为0.741,P = 0.009)。基于超声的NAFLD严重程度分级与患者代谢状况异常相关。基于超声,FRS与NAFLD严重程度增加相关。这些发现表明,NAFLD的存在可能是心血管风险增加的一个标志,可能有助于识别那些可能从更积极的治疗中获益以预防不良心血管事件发生的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b81/5516056/ecdfddb0fe9b/jcvtr-9-85-g001.jpg

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