Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia.
Department of Emergency Medicine, University Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia.
Can J Gastroenterol Hepatol. 2018 Aug 23;2018:8490242. doi: 10.1155/2018/8490242. eCollection 2018.
The aim of the study was to explore (a) prevalence and grade of nonalcoholic fatty liver (NAFL) among outpatients referred for abdominal ultrasound (US) examination and (b) relationship between the presence and severity of liver steatosis and metabolic syndrome (MS). This was a retrospective analysis of patients without history of liver disease examined by abdominal US in the University hospital setting. US was used to detect and semiquantitatively grade (0-3) liver steatosis. Data on patients' age, gender, body mass index (BMI), impaired glucose metabolism (IGM), atherogenic dyslipidaemia (AD), raised blood pressure (RBP), transaminases, and platelet counts were obtained from medical records. MS was defined as having at least 3 of the following components: obesity, IGM, AD, and RBP. Of the 631 patients (median age 60 years, median BMI 27.4 kg/m2, and 57.4% females) 71.5% were overweight and 48.5% had NAFL. In the subgroup of 159 patients with available data on the components of MS, patients with higher US grade of steatosis had significantly higher BMI and increased prevalence of obesity, IGM, AD, RBP, and accordingly more frequently had MS, whereas they did not differ in terms of age and gender. NAFL was independently associated with the risk of having MS in a multivariate model adjusted for age, gender, BMI, and IGM. The grade of liver steatosis did not correlate with the presence of liver fibrosis. We demonstrated worrisome prevalence of obesity and NAFL in the outpatient population from our geographic region. NAFL is independently associated with the risk of having MS implying worse prognosis.
(a) 因腹部超声(US)检查而就诊的门诊患者中非酒精性脂肪肝(NAFL)的患病率和严重程度;(b) 肝脏脂肪变性的存在和严重程度与代谢综合征(MS)之间的关系。这是一项在大学医院环境中对无肝脏疾病史且接受腹部 US 检查的患者进行的回顾性分析。US 用于检测和半定量分级(0-3 级)肝脏脂肪变性。从病历中获取患者的年龄、性别、体重指数(BMI)、葡萄糖代谢受损(IGM)、动脉粥样硬化性血脂异常(AD)、血压升高(RBP)、转氨酶和血小板计数等数据。MS 定义为至少存在以下 3 种成分:肥胖、IGM、AD 和 RBP。在 631 例患者(中位年龄 60 岁,中位 BMI 27.4kg/m2,57.4%为女性)中,71.5%超重,48.5%患有 NAFL。在 159 例可获得 MS 成分数据的患者亚组中,US 分级较高的患者 BMI 显著较高,肥胖、IGM、AD、RBP 的患病率增加,因此 MS 的发病率更高,而年龄和性别无差异。在调整年龄、性别、BMI 和 IGM 后,NAFL 与 MS 的发病风险独立相关。肝脏脂肪变性的严重程度与肝纤维化的存在无关。我们证明了我们所在地区门诊人群中肥胖症和 NAFL 的发病率令人担忧。NAFL 与 MS 的发病风险独立相关,提示预后更差。