Chalasani Sai, Mathur Karan, Shammas Nicole, Orman Eric, Vuppalanchi Raj, Lammert Craig
Indiana University School of Medicine, Indianapolis, IN.
Medicine (Baltimore). 2020 Oct 16;99(42):e22805. doi: 10.1097/MD.0000000000022805.
The prevalence and impact of hepatic steatosis among patients with autoimmune hepatitis (AIH) is not well described.We conducted a cross-sectional study to determine the prevalence of hepatic steatosis in AIH patients and examined its relationship with hepatic fibrosis using vibration controlled transient elastography. Liver stiffness measurement (LSM), controlled attenuation parameter (CAP), gender, current age, and body mass index (BMI) were collected from 277 AIH patients. Hepatic steatosis was defined as CAP >263 db/m.The study participants were mostly female (82%) with an average age of 49 years and BMI 29.7 kg/m. Mean LSM was 12.5 (standard deviation 13.5) kPa and CAP was 244 (standard deviation 63) db/m. The prevalence of coexisting steatosis was 33.2%, and steatosis did not correlate with LSM (r = 0.05, P = .46). In this study, only gender (females with 31% lower LSM on average compared to males, P = .001) and BMI (each unit increase of BMI resulted in a 1.48% increase on average LSM, P = .01) correlated with LSM. Male gender had significant association with increased LSM, after controlling for age, BMI, and CAP (P = .001).This exploratory study using noninvasive vibration controlled transient elastography revealed hepatic steatosis is highly prevalent in patients with AIH but not associated with liver fibrosis.
自身免疫性肝炎（AIH）患者中肝脂肪变性的患病率及影响尚未得到充分描述。我们进行了一项横断面研究，以确定AIH患者中肝脂肪变性的患病率，并使用振动控制瞬时弹性成像技术检查其与肝纤维化的关系。收集了277例AIH患者的肝脏硬度测量值（LSM）、控制衰减参数（CAP）、性别、当前年龄和体重指数（BMI）。肝脂肪变性定义为CAP>263 db/m。研究参与者大多为女性（82%），平均年龄49岁，BMI为29.7 kg/m。平均LSM为12.5（标准差13.5）kPa，CAP为244（标准差63）db/m。并存脂肪变性的患病率为33.2%，且脂肪变性与LSM无相关性（r = 0.05，P = 0.46）。在本研究中，仅性别（女性平均LSM比男性低31%，P = 0.001）和BMI（BMI每增加一个单位，平均LSM增加1.48%，P = 0.01）与LSM相关。在控制年龄、BMI和CAP后，男性与LSM升高显著相关（P = 0.001）。这项使用非侵入性振动控制瞬时弹性成像技术的探索性研究表明，肝脂肪变性在AIH患者中非常普遍，但与肝纤维化无关。
