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内脏肥胖是潜在活体肝供者中瘦型非酒精性脂肪性肝病的一个危险因素。

Visceral adiposity as a risk factor for lean non-alcoholic fatty liver disease in potential living liver donors.

机构信息

Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

J Gastroenterol Hepatol. 2021 Nov;36(11):3212-3218. doi: 10.1111/jgh.15597. Epub 2021 Jul 3.

Abstract

BACKGROUND AND AIM

This study aimed to investigate the relationship between hepatic steatosis (HS) evaluated by biopsy and visceral adiposity assessed by computed tomography in lean living liver donor candidates and to determine the risk factors for lean non-alcoholic fatty liver disease (NAFLD).

METHODS

This retrospective study included 250 lean (body mass index, < 23 kg/m ) potential living liver donors (mean age, 31.1 ± 8.6 years; 141 men) who had undergone liver biopsy and abdominal computed tomography between 2017 and 2018. Anthropometry, laboratory parameters, body composition, and the degree of HS were evaluated. Logistic regression was used to identify independent predictors of lean NAFLD.

RESULTS

The visceral fat area (VFA) was significantly correlated with the degree of HS in men (r = 0.408; P < 0.001) and women (r = 0.360; P < 0.001). The subcutaneous fat area was significantly correlated with the degree of HS in men (r = 0.398; P < 0.001), but not in women. The skeletal muscle area did not correlate with the degree of HS in either men or women. In the multivariable logistic regression analysis, the VFA (odds ratio [OR], 1.028; 95% confidence interval [CI], 1.013-1.044; P < 0.001) and subcutaneous fat area (OR, 1.016; 95% CI, 1.004-1.028; P = 0.009) were independent risk factors for lean NAFLD in men, and the VFA (OR, 1.036; 95% CI, 1.013-1.059; P = 0.002) was an independent risk factor for lean NAFLD in women.

CONCLUSIONS

The severity of non-alcoholic fatty liver was positively correlated with visceral fat accumulation in a lean Asian population. Visceral adiposity may be a risk factor for lean NAFLD in potential living liver donors.

摘要

背景与目的

本研究旨在探讨经肝活检评估的肝脂肪变(HS)与经计算机断层扫描评估的内脏肥胖在瘦型活体供肝候选者中的关系,并确定瘦型非酒精性脂肪性肝病(NAFLD)的危险因素。

方法

本回顾性研究纳入了 2017 年至 2018 年间接受过肝活检和腹部计算机断层扫描的 250 名瘦型(体重指数,<23 kg/m )潜在活体供肝者(平均年龄 31.1 ± 8.6 岁;男性 141 名)。评估了人体测量学、实验室参数、身体成分和 HS 程度。采用 logistic 回归分析确定瘦型 NAFLD 的独立预测因素。

结果

男性(r = 0.408;P < 0.001)和女性(r = 0.360;P < 0.001)的内脏脂肪面积(VFA)与 HS 程度显著相关。男性的皮下脂肪面积与 HS 程度显著相关(r = 0.398;P < 0.001),但女性则无此相关性。男性和女性的骨骼肌面积均与 HS 程度无相关性。在多变量 logistic 回归分析中,VFA(比值比[OR],1.028;95%置信区间[CI],1.013-1.044;P < 0.001)和皮下脂肪面积(OR,1.016;95%CI,1.004-1.028;P = 0.009)是男性瘦型 NAFLD 的独立危险因素,而 VFA(OR,1.036;95%CI,1.013-1.059;P = 0.002)是女性瘦型 NAFLD 的独立危险因素。

结论

在亚洲瘦型人群中,非酒精性脂肪性肝病的严重程度与内脏脂肪堆积呈正相关。内脏肥胖可能是潜在活体供肝者发生瘦型 NAFLD 的危险因素。

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