Choi Jaehyuk, Choi YoungRok, Hong Su Young, Suh Sanggyun, Hong Kwangpyo, Han Eui Soo, Lee Jeong-Moo, Hong Suk Kyun, Yi Nam-Joon, Lee Kwang-Woong, Suh Kyung-Suk
Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Front Surg. 2022 May 3;9:827526. doi: 10.3389/fsurg.2022.827526. eCollection 2022.
A short-term weight reduction program for potential living donors was introduced to reduce the extent of hepatic steatosis prior to liver transplantation. We aimed to investigate changes in non-invasive hepatic steatosis and fibrosis indices among those who completed the program.
Among 1,950 potential living liver donors between January 2011 and May 2019, 160 living donors joined the weight reduction program. The prospectively collected clinical data of these potential liver donors were analyzed retrospectively. Hepatic steatosis and fibrosis scores were determined using the fatty liver index (FLI), hepatic steatosis index (HSI), and NAFLD fibrosis score (NFS) and compared to MR spectroscopy (MRS) fat fraction results before and after weight reduction.
Thirty-nine potential living donors who had undergone MRS both before and after weight reduction were included in the analysis. Their body weight decreased from 78.02 ± 10.89 kg to 72.36 ± 10.38 kg over a mean of 71.74 ± 58.11 days. FLI, HSI, and MRS values decreased significantly from 41.52 ± 19.05 to 24.53 ± 15.93, 39.64 ± 3.74 to 35.06 ± 3.82, and 12.20 ± 4.05 to 6.24 ± 3.36, respectively. No significant decreases in NFS were observed. There was a significant correlation between the extent of HSI change and the extent of MRS change (R value = 0.69, < 0.001), although there was no correlation between MRS and FLI.
The weight reduction program significantly improved non-invasive indices of hepatic steatosis over a short period. HSI may allow for prediction of simple decreases in hepatic steatosis.
为潜在的活体供体引入了一项短期减重计划，以减少肝移植前肝脂肪变性的程度。我们旨在研究完成该计划者的非侵入性肝脂肪变性和纤维化指标的变化。
在2011年1月至2019年5月期间的1950名潜在活体肝供体中，160名活体供体参加了减重计划。对这些潜在肝供体前瞻性收集的临床数据进行回顾性分析。使用脂肪肝指数（FLI）、肝脂肪变性指数（HSI）和非酒精性脂肪性肝病纤维化评分（NFS）确定肝脂肪变性和纤维化评分，并与减重前后的磁共振波谱（MRS）脂肪分数结果进行比较。
分析纳入了39名在减重前后均接受MRS检查的潜在活体供体。他们的体重在平均71.74±58.11天内从78.02±10.89千克降至72.36±10.38千克。FLI、HSI和MRS值分别从41.52±19.05显著降至24.53±15.93、从39.64±3.74降至35.06±3.82、从12.20±4.05降至6.24±3.36。未观察到NFS有显著下降。HSI变化程度与MRS变化程度之间存在显著相关性（R值 = 0.69，P < 0.001），尽管MRS与FLI之间无相关性。
减重计划在短期内显著改善了肝脂肪变性的非侵入性指标。HSI可能有助于预测肝脂肪变性的单纯降低。
