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《欧洲非酒精性脂肪性肝病注册研究:一项真实世界的非酒精性脂肪性肝病纵向队列研究》。

The European NAFLD Registry: A real-world longitudinal cohort study of nonalcoholic fatty liver disease.

机构信息

Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.

Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.

出版信息

Contemp Clin Trials. 2020 Nov;98:106175. doi: 10.1016/j.cct.2020.106175. Epub 2020 Oct 9.

Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD), a progressive liver disease that is closely associated with obesity, type 2 diabetes, hypertension and dyslipidaemia, represents an increasing global public health challenge. There is significant variability in the disease course: the majority exhibit only fat accumulation in the liver but a significant minority develop a necroinflammatory form of the disease (non-alcoholic steatohepatitis, NASH) that may progress to cirrhosis and hepatocellular carcinoma. At present our understanding of pathogenesis, disease natural history and long-term outcomes remain incomplete. There is a need for large, well characterised patient cohorts that may be used to address these knowledge gaps and to support the development of better biomarkers and novel therapies. The European NAFLD Registry is an international, prospectively recruited observational cohort study that aims to establish a large, highly-phenotyped patient cohort and linked bioresource. Here we describe the infrastructure, data management and monitoring plans, and the standard operating procedures implemented to ensure the timely and systematic collection of high-quality data and samples. Already recruiting subjects at secondary/tertiary care centres across Europe, the Registry is supporting the European Union IMI2-funded LITMUS 'Liver Investigation: Testing Marker Utility in Steatohepatitis' consortium, which is a major international effort to robustly validate biomarkers that diagnose, risk stratify and/or monitor NAFLD progression and liver fibrosis stage. The European NAFLD Registry has the demonstrable capacity to support research and biomarker development at scale and pace.

摘要

非酒精性脂肪性肝病(NAFLD)是一种与肥胖、2 型糖尿病、高血压和血脂异常密切相关的进行性肝病,是一个日益严重的全球公共卫生挑战。该疾病的病程存在很大差异:大多数患者仅表现为肝脏脂肪堆积,但仍有相当一部分患者会发展为非酒精性脂肪性肝炎(NASH)的炎症坏死形式,可能会进展为肝硬化和肝细胞癌。目前,我们对发病机制、疾病自然史和长期结局的了解仍不完整。需要有大量、特征明确的患者队列,这些队列可用于解决这些知识空白,并支持更好的生物标志物和新疗法的开发。欧洲 NAFLD 注册中心是一项国际性、前瞻性招募的观察性队列研究,旨在建立一个大型、高度表型的患者队列和相关的生物资源库。本文介绍了其基础设施、数据管理和监测计划,以及实施的标准操作程序,以确保及时和系统地收集高质量的数据和样本。该注册中心已经在欧洲各地的二级/三级医疗机构招募受试者,支持欧盟 IMI2 资助的 LITMUS“肝脏研究:在脂肪性肝炎中测试标志物的实用性”联盟,这是一项重大的国际努力,旨在稳健验证用于诊断、风险分层和/或监测 NAFLD 进展和肝纤维化阶段的生物标志物。欧洲 NAFLD 注册中心有能力在规模和速度上支持研究和生物标志物的开发。

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