Suda Takeshi, Kanefuji Tsutomu, Abe Atsushi, Nagayama Itsuo, Hoshi Takahiro, Morita Shinichi, Yagi Kazuyoshi, Hatakeyama Shigeaki, Hayatsu Masafumi, Hasegawa Noboru, Terai Shuji
Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University.
Joetsu-Area General Health Care Center.
Medicine (Baltimore). 2019 Jan;98(2):e13958. doi: 10.1097/MD.0000000000013958.
To distinguish and characterize nonalcoholic steatohepatitis (NASH) candidates from among medical checkup visitor diagnosed with nonalcoholic fatty liver diseases (mcNAFLDs).A cut-off value has not been established to differentiate NASH at the earliest stage in NAFLD.Shear wave speed (SWS) was measured in the livers of 480 mcNAFLDs. NASH candidates were screened out by adopting a statistically defined cut-off value of SWS and were characterized in terms of food preference.SWS ranged between 1.11 and 2.18 m/s and fit a Gaussian distribution (r = 0.98) with an average and SD of 1.324 and 0.0847 m/s, respectively, in 320/160 males/females 64.4 (interquartile range 57.3-69.4) years old. The average plus SD (1.41 m/s) screened out 82 (17.1%) NASH candidates, who were significantly older (66.8 vs. 64.1 years old, P = 0.001) and had higher fibrosis 4 index values (1.58 vs. 1.33, P < 0.0001) than the remaining mcNAFLDs. The number of patients with a BMI greater than 25 kg/m was 118 (29.6%) mcNAFLDs and 34 (41.5%) NASH candidates, with a significantly higher frequency in NASH candidates (P = 0.05). Obese patients preferentially ate fatty acids in general, while NASH candidates preferred to consume several long-chain unsaturated fatty acids irrespective of their BMI.These results suggest that NASH candidates who have a longer disease duration and pathological progression can be distinguished from mcNAFLDs by a statistically defined cut-off value of SWS. The defined value indicates that there are different food habitats associated with obesity and NAFLD progression.
从诊断为非酒精性脂肪性肝病（mcNAFLD）的体检者中区分和表征非酒精性脂肪性肝炎（NASH）候选者。尚未确定在NAFLD最早阶段区分NASH的临界值。对480例mcNAFLD患者的肝脏进行了剪切波速度（SWS）测量。通过采用统计学定义的SWS临界值筛选出NASH候选者，并对其食物偏好进行了表征。在320名男性/160名女性、平均年龄64.4岁（四分位间距57.3 - 69.4岁）中，SWS范围为1.11至2.18米/秒，符合高斯分布（r = 0.98），平均值和标准差分别为1.324和0.0847米/秒。平均加标准差（1.41米/秒）筛选出82名（17.1%）NASH候选者，他们的年龄显著更大（66.8岁对64.1岁，P = 0.001），纤维化4指数值更高（1.58对1.33，P < 0.0001），高于其余mcNAFLD患者。体重指数（BMI）大于25 kg/m²的患者在mcNAFLD患者中有118例（29.6%），在NASH候选者中有34例（41.5%），在NASH候选者中的频率显著更高（P = 0.05）。肥胖患者一般优先摄入脂肪酸，而NASH候选者无论BMI如何都更喜欢摄入几种长链不饱和脂肪酸。这些结果表明，疾病持续时间和病理进展较长的NASH候选者可通过统计学定义的SWS临界值与mcNAFLD患者区分开来。该定义值表明肥胖和NAFLD进展存在不同的食物偏好情况。
