Gangireddy Venu Gopala Reddy, Pilkerton Courtney, Xiang Jun, Tinajero Ruben, Ashcraft Amie M
Department of Gastroenterology, United Hospital Center, Bridgeport, WV, USA.
Department of Family Medicine, West Virginia University, Morgantown, WV, USA.
J Obes Metab Syndr. 2022 Mar 30;31(1):61-69. doi: 10.7570/jomes21062.
Metabolic syndrome (MetS) is a group of factors associated with increased risks of cardiovascular disease and overall mortality. Nonalcoholic fatty liver disease (NAFLD) is a common disorder that has been shown to cause hepatic steatosis and fibrosis. The relationship between NAFLD and MetS appears to be bidirectional, but very few studies have examined the role of MetS in hepatic steatosis and fibrosis. The present study investigated the relationships between MetS and its components and the severity of hepatic fibrosis and steatosis, and fibrosis independent of steatosis.
The study was a cross-sectional population-based survey of 4,678 National Health and Nutrition Examination Survey participants from 2017 to 2018 in the United States. Hepatic fibrosis and steatosis were measured using liver elastography. The MetS components were assessed using demographic, examination, laboratory, and self-reported data.
Using survey-weighted population estimates, 26% of the population had steatosis, 7.5% had fibrosis, and 3.3% had fibrosis without steatosis. The adjusted odds ratio for any level of steatosis was 4.12 times higher (95% confidence interval [CI], 3.16-5.37) and any level of fibrosis was 3.34 times higher (95% CI, 2.26-4.94) among participants with MetS than those without. The adjusted odds ratio for fibrosis without steatosis is 2.67 times higher (95% CI, 1.47-4.87) among participants with MetS than those without.
The presence of MetS significantly increases the risk of hepatic fibrosis and steatosis, providing evidence for MetS to be considered an additional independent risk factor for hepatic fibrosis together with other known etiologies.
代谢综合征（MetS）是一组与心血管疾病风险增加及全因死亡率相关的因素。非酒精性脂肪性肝病（NAFLD）是一种常见疾病，已被证明可导致肝脂肪变性和纤维化。NAFLD与MetS之间的关系似乎是双向的，但很少有研究探讨MetS在肝脂肪变性和纤维化中的作用。本研究调查了MetS及其组成成分与肝纤维化和脂肪变性严重程度以及独立于脂肪变性的纤维化之间的关系。
该研究是一项基于人群的横断面调查，对2017年至2018年美国国家健康与营养检查调查的4678名参与者进行。使用肝脏弹性成像测量肝纤维化和脂肪变性。使用人口统计学、体格检查、实验室检查和自我报告的数据评估MetS的组成成分。
采用调查加权的人群估计值，26%的人群有脂肪变性，7.5%有纤维化，3.3%有无脂肪变性的纤维化。与无MetS的参与者相比，有MetS的参与者任何程度脂肪变性的校正优势比高4.12倍（95%置信区间[CI]，3.16 - 5.37），任何程度纤维化的校正优势比高3.34倍（95%CI，2.26 - 4.94）。与无MetS的参与者相比，有MetS的参与者无脂肪变性的纤维化校正优势比高2.67倍（95%CI，1.47 - 4.87）。
MetS的存在显著增加肝纤维化和脂肪变性的风险，为MetS与其他已知病因一起被视为肝纤维化的另一个独立危险因素提供了证据。
