Gastroenterology, Liver Unit, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHISA, CIBERehd, Madrid, Spain.
Expert Rev Gastroenterol Hepatol. 2019 Oct;13(10):1017-1022. doi: 10.1080/17474124.2019.1651644. Epub 2019 Aug 8.
: Central obesity, due to the accumulation of visceral fat(VF), is one of the main risk factors for venous thrombosis. The aim of this study was to determine if VF may be a risk factor for development of portal vein thrombosis(PVT) in cirrhotic patients.: A total of 214 cirrhotic patients at the outpatient clinic were consecutively included, undergoing an anthropometric evaluation, blood tests and bioimpedance.: Median MELDscore was10. Prior liver decompensation occurred in 44.9% of patients and 35.6% of patients had large esophageal varices. Mean body mass index was 28.7 Kg/m2 (39.3%were obese) and mean waist circumference(WC) was 103.8 cm. A 7.5% of patients had PVT at the time of inclusion. PVT was more frequent in males(93.8 vs. 68.2%, p = 0.03). Patients with PVT had a higher WC(111.9 vs. 103.2 cm, p = 0.02) and VF (17.1 vs. 14.5, p = 0.04). PVT was also more frequent in patients with prior decompensation (81.3 vs. 41.9%, p < 0.01) and with large esophageal varices(62.5 vs. 33.3%, p = 0.02). In the simplified multivariate analysis, PVT was independently associated with the presence of portal hypertension(OR 13, 95%CI 1.6-108.3, p = 0.02) and VF(OR 1.2, 95%CI 1.03-1.3, p = 0.01).: VF was independently associated with PVT in cirrhotic patients. VF may be more reliable than conventional anthropometric measurements for cirrhotic patients.
: 中心性肥胖，由于内脏脂肪(VF)的积累，是静脉血栓形成的主要危险因素之一。本研究旨在确定VF 是否可能是肝硬化患者门静脉血栓形成(PVT)发展的危险因素。: 共连续纳入 214 名门诊肝硬化患者，进行人体测量评估、血液检查和生物阻抗分析。中位 MELD 评分 10。44.9%的患者发生过先前的肝失代偿，35.6%的患者存在大的食管静脉曲张。平均体重指数为 28.7kg/m2(39.3%为肥胖)，平均腰围(WC)为 103.8cm。入组时，7.5%的患者存在 PVT。男性中 PVT 更常见(93.8%比 68.2%，p = 0.03)。PVT 患者的 WC(111.9 比 103.2cm，p = 0.02)和 VF(17.1 比 14.5，p = 0.04)更高。PVT 在先前失代偿的患者(81.3%比 41.9%，p < 0.01)和存在大的食管静脉曲张的患者中更为常见(62.5%比 33.3%，p = 0.02)。在简化的多变量分析中，PVT 与门静脉高压的存在独立相关(OR 13，95%CI 1.6-108.3，p = 0.02)和 VF(OR 1.2，95%CI 1.03-1.3，p = 0.01)。: VF 与肝硬化患者的 PVT 独立相关。VF 可能比传统的人体测量指标更能反映肝硬化患者的情况。
