Abdel-Razik Ahmed, Mousa Nasser, Shabana Walaa, Yassen Ahmed H, Abdelsalam Mostafa, Wahba Mohamed M, Helmy Eman Mohamed, Tawfik Ahmed M, Zalata Khaled, Hasan Ahmad S, Elhelaly Rania, Elzehery Rasha, Fathy Aya Ahmed, El-Wakeel Niveen, Eldars Waleed
Tropical Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Front Med (Lausanne). 2021 Apr 29;8:650818. doi: 10.3389/fmed.2021.650818. eCollection 2021.
Approximately 30-40% of portal vein thrombosis (PVT) remains of unknown origin. The association between non-alcoholic fatty liver disease (NAFLD) and PVT is a matter of debate. This study aimed to investigate the association between PVT and NAFLD. We included 94 out of 105 consecutive NAFLD patients in this prospective cohort study in addition to 94 from the healthy control group. We evaluated biochemical, clinical, immunological, and histopathological parameters; waist circumference (WC); leptin; adiponectin; and leptin/adiponectin ratio (LAR) for all participants at baseline and every 3 years thereafter. We described the characteristics of participants at baseline and showed individual WC, LAR, and PVT characteristics. Potential parameters to predict PVT development within 9 years were determined. PVT developed in eight (8.5%) patients, mainly in the portal trunk. Univariate analysis showed three PVT-associated factors: diabetes mellitus ( = 0.013), WC ( < 0.001), and LAR ( = 0.002). After adjusting multiple confounding variables, the multivariate model showed that the only significant variables were WC and LAR. By applying the receiver operating characteristic curve, WC had 98.8% specificity, 87.5% sensitivity, and 0.894 area under the curve (AUC) for prediction of PVT ( < 0.001) at cutoff values of > 105 cm. In comparison, LAR had 60.5% specificity, 87.5% sensitivity, and 0.805 AUC for PVT prediction ( < 0.001) at cutoff values of >7.5. This study suggests that increased central obesity and LAR were independently associated with PVT development in non-cirrhotic NAFLD patients, and they should be considered risk factors that may participate in PVT multifactorial pathogenesis.
约30%-40%的门静脉血栓形成（PVT）病因不明。非酒精性脂肪性肝病（NAFLD）与PVT之间的关联存在争议。本研究旨在调查PVT与NAFLD之间的关联。在这项前瞻性队列研究中，我们纳入了105例连续的NAFLD患者中的94例，另外还有94例来自健康对照组。我们评估了所有参与者在基线时以及此后每3年的生化、临床、免疫和组织病理学参数；腰围（WC）；瘦素；脂联素；以及瘦素/脂联素比值（LAR）。我们描述了基线时参与者的特征，并展示了个体WC、LAR和PVT的特征。确定了预测9年内PVT发生的潜在参数。8例（8.5%）患者发生了PVT，主要发生在门静脉主干。单因素分析显示了3个与PVT相关的因素：糖尿病（P=0.013）、WC（P<0.001）和LAR（P=0.002）。在调整多个混杂变量后，多变量模型显示唯一显著的变量是WC和LAR。通过应用受试者工作特征曲线，WC在预测PVT时，当截断值>105 cm时，特异性为98.8%，敏感性为87.5%，曲线下面积（AUC）为0.894（P<0.001）。相比之下，LAR在预测PVT时，当截断值>7.5时，特异性为60.5%，敏感性为87.5%，AUC为0.805（P<0.001）。本研究表明，中心性肥胖增加和LAR与非肝硬化NAFLD患者PVT的发生独立相关，它们应被视为可能参与PVT多因素发病机制的危险因素。
