Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkey.
Department of Medical Education, Marmara University, School of Medicine, Istanbul, Turkey.
Turk J Gastroenterol. 2021 Aug;32(8):661-666. doi: 10.5152/tjg.2021.20512.
Metabolic syndrome (MS) is a condition that consists of several disorders, and the individual impact of these disorders on metabolic dysfunction-associated fatty liver disease (MAFLD) is still not clear in a combined diagnosis of MS. In this study, we aimed to investigate the effect of MS on advanced fibrosis in patients with MAFLD.
We recruited the patients from our gastroenterology out-patient clinic who were being followed up for MAFLD. MAFLD was diagnosed with liver biopsy in all patients. The frequency of MS and other metabolic parameters were also compared between groups with advanced fibrosis and groups in which fibrosis was not as advanced.
In total, we enrolled 424 biopsy-proven MAFLD patients to the study. In univariate analysis, individuals with greater age, body mass index (BMI), higher aspartate transaminase (AST), MS, impaired fasting glucose, hypertension, enlarged waist circumference (WC), diabetes mellitus (DM), and women had significantly increased risk for fibrosis. In multivariate analysis, it was found that DM, greater age, higher BMI, and increased AST were seen more commonly in MAFLD patients with advanced fibrosis.
Greater age, a higher BMI, higher AST and a diagnosis of diabetes were more commonly associated with advanced fibrosis. However, DM was found to be the strongest predictive factor of advanced fibrosis in our cohort (OR: 2.495). Multivariate analyses did not indicate a significantly common occurrence of MS in the advanced fibrosis group, despite its important role in MAFLD pathophysiology.
代谢综合征(MS)是一种由多种疾病组成的病症,在代谢相关脂肪性肝病(MAFLD)的综合诊断中,这些疾病对代谢功能障碍相关脂肪性肝病的个体影响仍不清楚。在这项研究中,我们旨在研究 MS 对 MAFLD 患者晚期纤维化的影响。
我们从我们的消化科门诊招募了正在接受 MAFLD 随访的患者。所有患者均通过肝活检诊断为 MAFLD。还比较了纤维化程度较高组和纤维化程度较低组之间 MS 和其他代谢参数的频率。
共纳入 424 例经肝活检证实的 MAFLD 患者。在单因素分析中,年龄较大、体重指数(BMI)较高、天门冬氨酸转氨酶(AST)较高、MS、空腹血糖受损、高血压、腰围(WC)增大、糖尿病(DM)和女性的个体纤维化风险显著增加。多因素分析发现,DM、年龄较大、BMI 较高和 AST 升高在 MAFLD 患者中更常见纤维化。
更大的年龄、更高的 BMI、更高的 AST 和糖尿病的诊断与晚期纤维化更常见相关。然而,DM 是我们队列中晚期纤维化的最强预测因子(OR:2.495)。尽管 MS 在 MAFLD 发病机制中具有重要作用,但多变量分析并未表明 MS 在晚期纤维化组中发生的频率显著更高。