NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, California.
NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, California; Université Lyon 1, Hospices Civils de Lyon, Lyon, France.
Gastroenterology. 2018 Aug;155(2):307-310.e2. doi: 10.1053/j.gastro.2018.04.014. Epub 2018 Apr 13.
Markers are needed to predict progression of nonalcoholic fatty liver disease (NAFLD). The proton density fat fraction, measured by magnetic resonance imaging (MRI-PDFF), provides an accurate, validated marker of hepatic steatosis; however, it is not clear whether the PDFF identifies patients at risk for NAFLD progression. We performed a follow-up study of 95 well-characterized patients with biopsy-proven NAFLD and examined the association between liver fat content and fibrosis progression. MRI-PDFF measurements were made at study entry (baseline). Biopsies were collected from patients at baseline and after a mean time period of 1.75 years. Among patients with no fibrosis at baseline, a higher proportion of patients in the higher liver fat group (MRI-PDFF ≥15.7%) had fibrosis progression (38.1%) than in the lower liver fat group (11.8%) (P = .067). In multivariable-adjusted logistic regression models (adjusted for age, sex, ethnicity, and body mass index), patients in the higher liver fat group had a significantly higher risk of fibrosis progression (multivariable-adjusted odds ratio 6.7; 95% confidence interval 1.01-44.1; P = .049). Our findings associate higher liver fat content, measured by MRI-PDFF, with fibrosis progression.
需要标志物来预测非酒精性脂肪性肝病 (NAFLD) 的进展。质子密度脂肪分数 (MRI-PDFF) 的测量可提供肝脂肪变性的准确、经过验证的标志物；然而，尚不清楚 PDFF 是否可识别出有进展为 NAFLD 风险的患者。我们对 95 例经活检证实的 NAFLD 患者进行了随访研究，并检查了肝脏脂肪含量与纤维化进展之间的关系。MRI-PDFF 测量在研究入组时（基线）进行。基线时收集了患者的活检，并在平均 1.75 年的时间后再次收集。在基线时无纤维化的患者中，较高肝脏脂肪组（MRI-PDFF≥15.7%）的纤维化进展比例（38.1%）高于较低肝脏脂肪组（11.8%）（P=.067）。在多变量调整的逻辑回归模型中（调整了年龄、性别、种族和体重指数），较高肝脏脂肪组的纤维化进展风险显著更高（多变量调整的优势比 6.7；95%置信区间 1.01-44.1；P=.049）。我们的研究结果表明，MRI-PDFF 测量的较高肝脏脂肪含量与纤维化进展相关。
