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非酒精性脂肪性肝病合并2型糖尿病患者肝纤维化的决定因素

The Determinants of Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus.

作者信息

Dai Chia-Yen, Fang Tzu-Jung, Hung Wei-Wen, Tsai Hui-Ju, Tsai Yi-Chun

机构信息

Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

出版信息

Biomedicines. 2022 Jun 23;10(7):1487. doi: 10.3390/biomedicines10071487.

Abstract

Liver fibrosis is a key pathophysiology process in chronic liver disease. It is still unclear whether the impact of liver fibrosis is not fully realized in type 2 diabetes mellitus (T2D) patients with nonalcoholic fatty liver disease (NAFLD), and the factors affecting nonalcoholic steatohepatitis (NASH) or liver stiffness also remain unclear. The aim of this study was to evaluate the determinants of liver fibrosis and in T2D patients with NAFLD. Liver fibrosis and steatosis were measured using transient elastography (FibroScan). Of 226 T2D patients with NAFLD, 50 with liver fibrosis had higher body mass index, serum uric acid, triglyceride and glycated hemoglobin levels and lower high density lipoprotein levels than 176 without liver fibrosis. Multivariate analysis revealed that aging, obesity, sulfonylurea usage and high levels of AST increased the risk of liver fibrosis in T2D patients with NAFLD. Our findings provide useful information to clinical physicians for earlier detection of liver fibrosis in T2D patients with NAFLD and to prevent liver fibrosis through controlling these risk factors.

摘要

肝纤维化是慢性肝病的关键病理生理过程。在患有非酒精性脂肪性肝病(NAFLD)的2型糖尿病(T2D)患者中,肝纤维化的影响是否未得到充分认识仍不清楚,影响非酒精性脂肪性肝炎(NASH)或肝脏硬度的因素也尚不明确。本研究的目的是评估T2D合并NAFLD患者肝纤维化的决定因素。使用瞬时弹性成像(FibroScan)测量肝纤维化和脂肪变性。在226例T2D合并NAFLD患者中,50例有肝纤维化的患者比176例无肝纤维化的患者具有更高的体重指数、血清尿酸、甘油三酯和糖化血红蛋白水平,以及更低的高密度脂蛋白水平。多变量分析显示,衰老、肥胖、使用磺脲类药物和高水平的谷草转氨酶增加了T2D合并NAFLD患者肝纤维化的风险。我们的研究结果为临床医生早期发现T2D合并NAFLD患者的肝纤维化,并通过控制这些危险因素预防肝纤维化提供了有用信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbc/9312509/fd996291f2cb/biomedicines-10-01487-g001.jpg

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