Department of Endocrinology and Nutrition, Hospital Universitario Germans Trias I Pujol, Badalona, Barcelona, Spain.
Unitat de Suport a la Recerca (USR) Metropolitana Nord, Fundació Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAP Jordi Gol), Mataró, Spain.
Front Endocrinol (Lausanne). 2023 Jan 13;13:1051958. doi: 10.3389/fendo.2022.1051958. eCollection 2022.
To investigate longitudinal changes in the liver stiffness measurement (LSM) in the general adult population without known liver disease and to describe its association with metabolic risk factors, with a special focus on subjects with non-alcoholic fatty liver disease (NAFLD) and dysglycemia.
A longitudinal adult population-based cohort study was conducted in Catalonia. LSM was measured by transient elastography (TE) at baseline and follow-up (median: 4.2 years). Subgroup with NAFLD and dysglycemia were analyzed. Moderate-to-advanced liver fibrosis was defined as LSM ≥8.0 kPa and LSM ≥9.2 kPa respectively.
Among 1.478 subjects evaluated, the cumulative incidence of LSM ≥8.0 kPa and ≥9.2 kPa at follow-up was 2.8% and 1.9%, respectively. This incidence was higher in NAFLD (7.1% for LSM ≥8.0 kPa and 5% for LSM ≥9.2 kPa) and dysglycemia (6.2% for LSM ≥8.0 kPa and 4.7% for LSM ≥9.2 kPa) subgroups. In the global cohort, the multivariate analyses showed that dysglycemia, abdominal obesity and atherogenic dyslipidemia were significantly associated with progression to moderate-to-advanced liver fibrosis. Female sex was negatively associated. In subjects with NAFLD, abdominal obesity and dysglycemia were associated with changes in LSM to ≥8.0 kPa and ≥9.2 kPa at follow-up. A decline in LSM value to <8 kPa was observed in 64% of those subjects with a baseline LSM ≥8.0 kPa.
In this population study, the presence of abdominal obesity and dysglycemia were the main risk metabolic factors associated with moderate-to-advanced liver fibrosis development over time in general populations as well as in subjects with NAFLD.
研究无已知肝病的一般成年人群中肝硬度测量（LSM）的纵向变化，并描述其与代谢危险因素的关系，特别关注非酒精性脂肪性肝病（NAFLD）和糖代谢异常患者。
在加泰罗尼亚进行了一项基于成年人的纵向队列研究。在基线和随访时（中位数：4.2 年）通过瞬时弹性成像（TE）测量 LSM。分析了伴有 NAFLD 和糖代谢异常的亚组。将中-重度肝纤维化定义为 LSM≥8.0kPa 和 LSM≥9.2kPa。
在评估的 1478 名受试者中，随访时 LSM≥8.0kPa 和 LSM≥9.2kPa 的累积发生率分别为 2.8%和 1.9%。在伴有 NAFLD（LSM≥8.0kPa 的发生率为 7.1%，LSM≥9.2kPa 的发生率为 5%）和糖代谢异常（LSM≥8.0kPa 的发生率为 6.2%，LSM≥9.2kPa 的发生率为 4.7%）的亚组中，该发生率更高。在全队列中，多变量分析显示糖代谢异常、腹部肥胖和动脉粥样硬化性血脂异常与进展为中-重度肝纤维化显著相关。女性呈负相关。在伴有 NAFLD 的患者中，腹部肥胖和糖代谢异常与随访时 LSM 增加至≥8.0kPa 和≥9.2kPa相关。在基线 LSM≥8.0kPa 的患者中，有 64%的患者 LSM 值下降至<8kPa。
在这项人群研究中，腹部肥胖和糖代谢异常是一般人群以及伴有 NAFLD 的患者中与中-重度肝纤维化随时间进展相关的主要代谢危险因素。
