Minerva Foundation Institute for Medical Research, Helsinki, Finland.
Department of Medicine, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland.
Sci Rep. 2017 Nov 6;7(1):14561. doi: 10.1038/s41598-017-14706-0.
Liver fat can be non-invasively measured by proton magnetic resonance spectroscopy (H-MRS) and fibrosis estimated as stiffness using transient elastography (FibroScan). There are no longitudinal data on changes in liver fat in Europids or on predictors of liver stiffness using these methods. We determined liver fat (H-MRS) and clinical characteristics including features of insulin resistance at baseline and after a median follow-up period of 11.3 (range 7.3-13.4) years in 97 Finnish subjects. Liver stiffness was measured at 11.3 years. Liver fat content decreased by 5% (p < 0.05) over time. Values at baseline and 11.3 years were closely interrelated (r = 0.81, p < 0.001). Baseline liver fat (OR 1.32; 95%CI: 1.15-1.50) and change in BMI (OR 1.67; 95%CI: 1.24-2.25) were independent predictors of liver fat at 11.3 years (AUROC 0.90; 95%CI: 0.83-0.96). Baseline liver fat (AUROC 0.84; 95%CI: 0.76-0.92) predicted liver fat at 11.3 years more accurately than routinely available parameters (AUROC 0.76; 95%CI: 0.65-0.86, p = 0.02). At 11.3 years, 29% of the subjects had increased liver stiffness. Baseline liver fat (OR 2.17; 95%CI: 1.05-4.46) was an independent predictor of increased liver stiffness. These data show that liver fat is more important than the associated metabolic abnormalities as the predictor of future liver fat and fibrosis.
肝脏脂肪可以通过质子磁共振波谱（H-MRS）进行非侵入性测量，纤维化可以通过瞬态弹性成像（FibroScan）来估计肝脏硬度。目前尚无关于白种人群肝脏脂肪变化的纵向数据，也没有使用这些方法预测肝脏硬度的指标。我们在 97 名芬兰受试者中，分别于基线和中位随访 11.3 年（范围 7.3-13.4 年）时测定肝脏脂肪（H-MRS）和临床特征，包括胰岛素抵抗的特征。在 11.3 年内，肝脏硬度值降低了 5%（p<0.05）。基线和 11.3 年的值密切相关（r=0.81，p<0.001）。基线肝脏脂肪（OR 1.32；95%CI：1.15-1.50）和 BMI 变化（OR 1.67；95%CI：1.24-2.25）是 11.3 年时肝脏脂肪的独立预测因子（AUROC 0.90；95%CI：0.83-0.96）。基线肝脏脂肪（AUROC 0.84；95%CI：0.76-0.92）比常规可用参数（AUROC 0.76；95%CI：0.65-0.86，p=0.02）更准确地预测 11.3 年时的肝脏脂肪。在 11.3 年内，29%的受试者肝脏硬度增加。基线肝脏脂肪（OR 2.17；95%CI：1.05-4.46）是肝脏硬度增加的独立预测因子。这些数据表明，肝脏脂肪比相关的代谢异常更重要，是未来肝脏脂肪和纤维化的预测指标。
