Department of Infectious Diseases, First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.
Emergency Department, First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.
Can J Gastroenterol Hepatol. 2019 Oct 15;2019:6028952. doi: 10.1155/2019/6028952. eCollection 2019.
We aimed at analyzing the role of smoking in hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and at exploring the related risk factors.
This was a cross-sectional study that included a total of 225 patients with NAFLD. Among them, 127 were nonsmokers and 98 were smokers. Liver significant fibrosis was diagnosed when the liver stiffness (LS) value was higher than 7.4 kPa. The diagnostic criterion for NAFLD was a controlled attenuation parameter (CAP) value of >238 dB/m. The CAP and LS values were measured using FibroScan.
FibroScan showed that the LS value in the smokers was significantly higher than that in the nonsmokers (10.12 ± 10.38 kPa vs. 7.26 ± 6.42 kPa, =0.013). The proportions of patients with liver significant fibrosis and advanced liver fibrosis among the smokers were significantly higher than those among the nonsmokers (=0.046). Univariate analysis showed that age, weight, high AST level, low PLT level, and smoking were the risk factors associated with liver fibrosis in the smokers with NAFLD while multivariate analysis showed that age (OR = 1.029, =0.021), high AST level (OR = 1.0121, =0.025), and smoking (OR = 1.294, =0.015) were the independent risk factors associated with liver fibrosis in the patients with NAFLD. Moreover, high AST level (OR = 1.040, =0.029), smoking index (OR = 1.220, =0.019), and diabetes mellitus (OR = 1.054, =0.032) were the independent risk factors for liver fibrosis among the smokers with NAFLD.
This study showed that smoking was closely associated with liver fibrosis among the patients with NAFLD. For patients with NAFLD who smoke, priority screening and timely intervention should be provided if they are at risk of liver fibrosis.
本研究旨在分析非酒精性脂肪性肝病（NAFLD）患者肝纤维化中吸烟的作用，并探讨相关危险因素。
这是一项横断面研究，共纳入 225 例 NAFLD 患者。其中，127 例为非吸烟者，98 例为吸烟者。当肝硬度（LS）值高于 7.4 kPa 时诊断为显著肝纤维化。NAFLD 的诊断标准为受控衰减参数（CAP）值>238 dB/m。使用 FibroScan 测量 CAP 和 LS 值。
FibroScan 显示，吸烟者的 LS 值明显高于非吸烟者（10.12±10.38 kPa 比 7.26±6.42 kPa，=0.013）。吸烟者中存在显著肝纤维化和晚期肝纤维化的患者比例明显高于非吸烟者（=0.046）。单因素分析显示，年龄、体重、AST 水平升高、血小板计数降低和吸烟是与 NAFLD 吸烟者肝纤维化相关的危险因素，而多因素分析显示，年龄（OR=1.029，=0.021）、AST 水平升高（OR=1.0121，=0.025）和吸烟（OR=1.294，=0.015）是与 NAFLD 患者肝纤维化相关的独立危险因素。此外，AST 水平升高（OR=1.040，=0.029）、吸烟指数（OR=1.220，=0.019）和糖尿病（OR=1.054，=0.032）是 NAFLD 吸烟者肝纤维化的独立危险因素。
本研究表明，吸烟与 NAFLD 患者肝纤维化密切相关。对于吸烟的 NAFLD 患者，如果存在肝纤维化风险，应优先进行筛查并及时干预。
