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原发性胆汁性胆管炎的肝脂肪变性严重程度和脂质特征。

The liver steatosis severity and lipid characteristics in primary biliary cholangitis.

机构信息

Capital Medical University, No 8, Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.

Capital Medical University, Beijing, China.

出版信息

BMC Gastroenterol. 2021 Oct 22;21(1):395. doi: 10.1186/s12876-021-01974-4.

Abstract

BACKGROUND

Patients with primary biliary cholangitis (PBC) often have comorbid dyslipidemia, and determining the degree of hepatic steatosis can help predict the risk of cardiovascular events in PBC patients. The aim of our study was to analyze the characteristics of lipid distribution and the degree of hepatic steatosis in PBC.

METHODS

We retrospectively analyzed 479 cases of PBC, chronic hepatitis B (CHB), chronic hepatitis C (CHC), non-alcoholic fatty liver disease (NAFLD), and healthy subjects (Normal) diagnosed by liver biopsy or definitive clinical diagnosis. Controlled attenuation parameter (CAP) values were applied to assess the degree of steatosis of the liver, and lipid levels were also compared in the five cohorts.

RESULTS

We found that among the five groups of subjects, the PBC group had the lowest CAP values (P < 0.001), and the high-density lipoprotein cholesterol (HDL-C) level in the PBC group was higher than normal, CHC and CHB group (P = 0.004, P = 0.033, P < 0.001, respectively).In the multivariate linear analysis, only BMI (β = 1.280, P = 0.028), ALP (β = - 0.064, P = 0.012), TBA (β = - 0.126, P = 0.020), TG (β = 12.520, P = 0.000), HDL-C (β = - 11.338, P = 0.001) and LDL-C (β = 7.012, P = 0.002) were independent predictors of CAP.

CONCLUSIONS

Among PBC, CHB, CHC, NAFLD and healthy subjects, PBC had the lowest degree of hepatic steatosis and higher HDL-C levels, all of which were found to be protective factors against atherosclerosis and cardiovascular risk and would provide a valuable reference for the risk of developing cardiovascular events in PBC patients.

摘要

背景

原发性胆汁性胆管炎(PBC)患者常伴有血脂异常,而肝脂肪变性程度的确定有助于预测 PBC 患者发生心血管事件的风险。本研究旨在分析 PBC 患者的脂类分布特征和肝脂肪变性程度。

方法

回顾性分析了 479 例经肝活检或明确临床诊断的 PBC、慢性乙型肝炎(CHB)、慢性丙型肝炎(CHC)、非酒精性脂肪性肝病(NAFLD)和健康对照(Normal)患者。应用受控衰减参数(CAP)值评估肝脏脂肪变性程度,并比较五组患者的血脂水平。

结果

发现五组受试者中,PBC 组的 CAP 值最低(P<0.001),且 PBC 组的高密度脂蛋白胆固醇(HDL-C)水平高于正常组、CHC 组和 CHB 组(P=0.004、P=0.033、P<0.001)。多因素线性分析显示,仅 BMI(β=1.280,P=0.028)、ALP(β=-0.064,P=0.012)、TBA(β=-0.126,P=0.020)、TG(β=12.520,P=0.000)、HDL-C(β=-11.338,P=0.001)和 LDL-C(β=7.012,P=0.002)是 CAP 的独立预测因素。

结论

在 PBC、CHB、CHC、NAFLD 和健康对照者中,PBC 患者的肝脂肪变性程度最低,HDL-C 水平最高,均为动脉粥样硬化和心血管风险的保护因素,为预测 PBC 患者发生心血管事件的风险提供了有价值的参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1da/8532358/026a73042057/12876_2021_1974_Fig1_HTML.jpg

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