García-Carretero R, Barquero-Pérez O, Mora-Jiménez I, Soguero-Ruiz C, Goya-Esteban R, Rodríguez-Castro C, Ramos-López J
Servicio de Medicina Interna, Hospital Universitario de Móstoles, Universidad Rey Juan Carlos, Móstoles, Madrid, España.
Teoría de la Señal y las Comunicaciones y Sistemas Telemáticos y Computación, Universidad Rey Juan Carlos, Móstoles, Madrid, España.
Hipertens Riesgo Vasc. 2019 Jul-Sep;36(3):130-136. doi: 10.1016/j.hipert.2018.10.001. Epub 2019 Jan 14.
Non-alcoholic fatty liver is a chronic liver disease in which fat is deposited in the liver, causing an inflammation called non-alcoholic steatohepatitis (NASH), and fibrosis. NASH is associated with metabolic syndrome (MS) and other cardiovascular risk factors. The aim of this study was to analyse the epidemiological features of NASH within a hypertensive population, with a high prevalence of MS, and to determine the features related to NASH.
The computerised records were collected from 3,473 patients from Mostoles University Hospital's Hypertension Unit in order to perform a retrospective, cross-sectional study. NASH was considered as ultrasound-detected fatty liver disease along with serum levels of alanine aminotransferase or aspartate aminotransferase 1.5 times above normal values, having ruled out other causes of liver disease: alcohol abuse, autoimmune hepatitis, drug toxicity, virus and hemochromatosis. A univariate, multivariate, and ANOVA analysis were performed to assess the effect of the studied features on the response of interest.
The cohort included 2,242 patients (51.3% men). NASH was present in 255 patients (11.4%) of whom 71% were men. MS was detected in 52.6% of patients (69.4% in the NASH group, and 50.5% in the non-NASH group, P=.001). Prevalence of type 2 diabetes mellitus was 11.5% (16.5% in the NASH group, and 10.8% in the non-NASH group, P=.01). In a multivariate analysis, waist circumference, MS, body mass index, type 2 diabetes mellitus, age, fasting serum insulin, and serum ferritin were associated with NASH. ANOVA revealed that NASH and transaminases were also significantly associated with components of metabolic syndrome.
In the population studied, MS, type 2 diabetes mellitus, and several components of MS were independently associated with NASH. Therefore, NASH can be considered as the liver manifestation of MS in patients with arterial hypertension.
非酒精性脂肪性肝病是一种慢性肝病，脂肪在肝脏中沉积，引发一种名为非酒精性脂肪性肝炎（NASH）的炎症以及纤维化。NASH与代谢综合征（MS）及其他心血管危险因素相关。本研究旨在分析高血压人群中NASH的流行病学特征（该人群MS患病率较高），并确定与NASH相关的特征。
收集了莫斯托莱斯大学医院高血压科3473例患者的计算机化记录，以进行一项回顾性横断面研究。NASH被定义为超声检测到的脂肪性肝病，同时血清丙氨酸氨基转移酶或天冬氨酸氨基转移酶水平高于正常值1.5倍，且已排除其他肝病病因：酗酒、自身免疫性肝炎、药物毒性、病毒感染和血色素沉着症。进行单因素、多因素和方差分析，以评估所研究特征对感兴趣反应的影响。
该队列包括2242例患者（51.3%为男性）。255例患者（11.4%）存在NASH，其中71%为男性。52.6%的患者检测到MS（NASH组为69.4%，非NASH组为50.5%，P = 0.001）。2型糖尿病患病率为11.5%（NASH组为16.5%，非NASH组为10.8%，P = 0.01）。在多因素分析中，腰围、MS、体重指数、2型糖尿病、年龄、空腹血清胰岛素和血清铁蛋白与NASH相关。方差分析显示，NASH和转氨酶也与代谢综合征的组分显著相关。
在所研究的人群中，MS、2型糖尿病和MS的几个组分与NASH独立相关。因此，NASH可被视为动脉高血压患者MS的肝脏表现。
