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巴西某大学医院非酒精性脂肪性肝病患者发生晚期肝纤维化的风险预测因素调查。

Risk predictors of advanced hepatic fibrosis in patients with nonalcoholic fatty liver disease - a survey in a university hospital in Brazil.

机构信息

Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

Divisão de Gastroenterologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

出版信息

Arch Endocrinol Metab. 2022 Nov 17;66(6):823-830. doi: 10.20945/2359-3997000000514. Epub 2022 Sep 20.

Abstract

OBJECTIVE

Describe the clinical profile of patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD) and analyze the risk predictors of hepatic fibrosis in outpatient follow-up at a university hospital.

METHODS

Demographic, clinical and laboratory data of a cohort of 143 patients with biopsy-proven NAFLD were retrospectively analysed under univariate analyses. Diagnostic accuracy, determined by AUROC, was evaluated for variables that showed a significant difference in univariate comparison analysis and diagnostic performances were determined by sensitivity and specificity.

RESULTS

The mean age of studied patients were 48 years, 66.4% of them were women. Age, presence of diabetes mellitus, hypertension, metabolic syndrome and laboratory variables such as AST/ALT ratio, GGT, platelet count and fasting glucose were significantly associated with advanced fibrosis. FIB-4 and NAFLD fibrosis score (AUROC 0.82 and 0.89, respectively) outperformed APRI (AUROC 0.73) for advanced liver fibrosis and cirrhosis ( of 0.04).

CONCLUSION

In our study, metabolic syndrome, diabetes, hypertension, AST/ALT ratio, GGT, platelet count and fasting glucose were associated with hepatic fibrosis in patients with NAFLD. The non-invasive tests FIB-4 and NAFLD fibrosis score showed the best accuracy to stratify disease severity.

摘要

目的

描述经肝活检证实的非酒精性脂肪性肝病(NAFLD)患者的临床特征,并分析大学附属医院门诊随访中肝纤维化的风险预测因子。

方法

对 143 例经肝活检证实的 NAFLD 患者的回顾性分析了人口统计学、临床和实验室数据。在单因素比较分析中显示出显著差异的变量进行了单因素分析,并通过 AUROC 评估了其诊断准确性,通过灵敏度和特异性确定了诊断性能。

结果

研究患者的平均年龄为 48 岁,其中 66.4%为女性。年龄、糖尿病、高血压、代谢综合征以及 AST/ALT 比值、GGT、血小板计数和空腹血糖等实验室变量与晚期纤维化显著相关。FIB-4 和 NAFLD 纤维化评分(AUROC 分别为 0.82 和 0.89)在预测晚期肝纤维化和肝硬化(差异为 0.04)方面优于 APRI(AUROC 为 0.73)。

结论

在我们的研究中,代谢综合征、糖尿病、高血压、AST/ALT 比值、GGT、血小板计数和空腹血糖与 NAFLD 患者的肝纤维化相关。非侵入性检测 FIB-4 和 NAFLD 纤维化评分显示了最佳的疾病严重程度分层准确性。

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