Hirooka Masashi, Koizumi Yohei, Miyake Teruki, Watanabe Takao, Yoshida Osamu, Tokumoto Yoshio, Yukimoto Atsushi, Nakamura Yoshiko, Imai Yusuke, Abe Masanori, Hiasa Yoichi
Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan.
Hepatol Commun. 2017 Jul 27;1(7):623-633. doi: 10.1002/hep4.1070. eCollection 2017 Sep.
A change in hepatic blood flow caused by the hepatic arterial buffer response (HABR) occurs as fatty liver disease progress. The aim of this longitudinal cohort study was to investigate whether fatty liver with the HABR induces metabolic disorders. In 2009 and 2010, 494 (89.5%) participants were enrolled. The median follow-up duration was 5.0 (interquartile range, 3.9-6.0) years. The hazard ratios of fatty liver with the HABR for incident metabolic disorders were assessed by Cox proportional hazard models. A non-fatty liver group (non-FL group, hepatorenal echo intensity ratio <1.12), a fatty liver without portal hypertension (FL group, hepatorenal echo intensity ratio ≥1.12 and ratio of the maximal blood velocity in the right hepatic artery to maximal blood velocity in the right portal vein <3.1) group, and a fatty liver with portal hypertension (FL-HABR group, hepatorenal echo intensity ratio ≥1.12 and ratio of the maximal blood velocity in the right hepatic artery to maximal blood velocity in the right portal vein ≥3.1) group were defined based on echo intensity and Doppler ultrasonography. Fatty liver with and without the HABR was significantly associated with the incidence of diabetes on multivariate analysis (non-FL versus FL group, hazard ratio, 3.36; 95% confidence interval, 1.05-12.85; FL versus FL with the HABR group, HR, 2.68; 95% confidence interval, 1.28-6.04). With respect to the incidence of hypertension and dyslipidemia, only FL with the HABR was a significant factor (hypertension, non-FL versus FL, = 0.874, FL versus FL-HABR, = 0.016, non-FL versus FL-HABR, = 0.023; dyslipidemia, non-FL versus FL, = 0.311, FL versus FL-HABR, = 0.194, non-FL versus FL-HABR, = 0.038). : Fatty liver with the HABR is a high-risk condition for metabolic diseases. ( 2017;1:623-633).
随着脂肪性肝病的进展，肝动脉缓冲反应（HABR）会引起肝血流的变化。这项纵向队列研究的目的是调查伴有HABR的脂肪肝是否会诱发代谢紊乱。在2009年和2010年，共有494名（89.5%）参与者入组。中位随访时间为5.0年（四分位间距为3.9 - 6.0年）。通过Cox比例风险模型评估伴有HABR的脂肪肝发生代谢紊乱的风险比。根据回声强度和多普勒超声检查，定义了一个非脂肪肝组（非FL组，肝肾回声强度比<1.12）、一个无门静脉高压的脂肪肝组（FL组，肝肾回声强度比≥1.12且右肝动脉最大血流速度与右门静脉最大血流速度之比<3.1）和一个伴有门静脉高压的脂肪肝组（FL - HABR组，肝肾回声强度比≥1.12且右肝动脉最大血流速度与右门静脉最大血流速度之比≥3.1）。多因素分析显示，伴有和不伴有HABR的脂肪肝均与糖尿病的发生率显著相关（非FL组与FL组相比，风险比为3.36；95%置信区间为1.05 - 12.85；FL组与伴有HABR的FL组相比，HR为2.68；95%置信区间为1.28 - 6.04）。关于高血压和血脂异常的发生率，只有伴有HABR的FL是一个显著因素（高血压，非FL组与FL组相比，P = 0.874，FL组与FL - HABR组相比，P = 0.016，非FL组与FL - HABR组相比，P = 0.023；血脂异常，非FL组与FL组相比，P = 0.311，FL组与FL - HABR组相比，P = 0.194，非FL组与FL - HABR组相比，P = 0.038）。结论：伴有HABR的脂肪肝是代谢性疾病的高危情况。（《[期刊名称]》2017年；第1卷：623 - 633页） （注：原文中未明确给出期刊名称，翻译时用[期刊名称]表示）
