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非酒精性脂肪性肝病中肌肉减少症与脂肪性肝炎及晚期肝纤维化的关系:一项荟萃分析

Relationship of sarcopenia with steatohepatitis and advanced liver fibrosis in non-alcoholic fatty liver disease: a meta-analysis.

作者信息

Yu Rui, Shi Qiangwei, Liu Lei, Chen Lidong

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

BMC Gastroenterol. 2018 Apr 19;18(1):51. doi: 10.1186/s12876-018-0776-0.

Abstract

BACKGROUND

Several studies have emerged indicating that sarcopenia is associated with nonalcoholic fatty liver disease, we aimed to systematically review and quantify the association between sacropenia and the histological severity of nonalcoholic fatty liver disease.

METHODS

Pubmed, the Cochrane Library and EMBASE were searched (until August 2017) for studies examining the relationship of sarcopenia with steatohepatitis and advanced liver fibrosis in nonalcoholic fatty liver disease. Pooled odds ratios were estimated by fixed effects models.

RESULTS

Three articles met our inclusion criteria, with a total of 3226 individuals. Two of the studies examined the association between sacropenia and steatohepatitis, a significant association was documented between sarcopenia and steatohepatitis (OR = 2.35, 95%CI 1.45, 3.81). All of the three studies assessed the association between sacropenia and advanced liver fibrosis, a significant association between sarcopenia and advanced liver fibrosis (OR = 2.41, 95%CI 1.94, 2.98). No significant heterogeneity was detected among studies in all comparisons. These results remained essentially unchanged after excluding any of the studies in the sensitivity analysis.

CONCLUSIONS

Sarcopenia in patients with nonalcoholic fatty liver disease is associated with a higher likelihood of having steatohepatitis or advanced liver fibrosis. Demonstration of the role of sarcopenia in nonalcoholic fatty liver disease development in future studies could have important therapeutic implications.

摘要

背景

多项研究表明,肌肉减少症与非酒精性脂肪性肝病有关,我们旨在系统评价并量化肌肉减少症与非酒精性脂肪性肝病组织学严重程度之间的关联。

方法

检索了PubMed、Cochrane图书馆和EMBASE(截至2017年8月),以查找研究肌肉减少症与非酒精性脂肪性肝病中脂肪性肝炎和晚期肝纤维化关系的研究。采用固定效应模型估计合并比值比。

结果

3篇文章符合纳入标准,共纳入3226例个体。其中2项研究探讨了肌肉减少症与脂肪性肝炎之间的关联,结果显示肌肉减少症与脂肪性肝炎之间存在显著关联(OR = 2.35,95%CI 1.45,3.81)。3项研究均评估了肌肉减少症与晚期肝纤维化之间的关联,结果显示肌肉减少症与晚期肝纤维化之间存在显著关联(OR = 2.41,95%CI 1.94,2.98)。所有比较中各研究间均未检测到显著异质性。敏感性分析中排除任何一项研究后,这些结果基本保持不变。

结论

非酒精性脂肪性肝病患者的肌肉减少症与发生脂肪性肝炎或晚期肝纤维化的可能性较高有关。在未来研究中证实肌肉减少症在非酒精性脂肪性肝病发展中的作用可能具有重要的治疗意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c59/5907709/2407e82ceb86/12876_2018_776_Fig1_HTML.jpg

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