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一种用于评估非肥胖型2型糖尿病合并非酒精性脂肪性肝病患者肝脂肪变性严重程度及纤维化风险的非侵入性方法。

A non-invasive method for estimating the severity of liver steatosis and the risk of fibrosis in non-obese type 2 diabetes patients with NAFLD.

作者信息

Mitrovic B, Gluvic Z, Klisic A, Obradovic M, Macut D, Tomasevic R, Isenovic E R

机构信息

Zemun Clinical Hospital, Faculty of Medicine, University of Belgrade - Department of Endocrinology and Diabetes, Belgrade, Serbia.

Primary Health Care Center, University of Montenegro, Faculty of Medicine, Podgorica, Montenegro.

出版信息

Acta Endocrinol (Buchar). 2022 Oct-Dec;18(4):480-487. doi: 10.4183/aeb.2022.480.

Abstract

CONTEXT

Prognostic considerations include assessing the risk of liver fibrosis in people with non-alcoholic fatty liver disease (NAFLD).

OBJECTIVES

This study evaluates the use of hematologic and metabolic parameters regarding liver steatosis and fibrosis scores (FLI and Fib-4) in non-obese type 2 diabetes mellitus (t2DM) patients with NAFLD.

METHODS

Subjects underwent abdominal ultrasound examinations, and FLI and Fib-4 scores were calculated to evaluate liver steatosis and the risk of liver fibrosis non-invasively: 61 non-obese NAFLD subjects with t2DM were included in the cohort study and were divided into 2 groups depending on the t2DM treatment regimen.

RESULTS

Fib-4 and WBC count demonstrated a significant inverse correlation (OR = 0.509, p = 0.007). WBC count had an R2 of 0.237, indicating that this marker could account for up to 23.7% of a variation in Fib-4. Fib-4 and FFA had positive correlation which did not achieve statistically significant prediction (OR=7.122, p=0.062). Additionally, a significant prediction of HbA1c (OR=1.536, p=0.016) and haemoglobin (OR=1.071, p=0.020) for FLI was revealed.

CONCLUSION

HbA1c and other haematological and metabolic parameters, such as haemoglobin and WBC, may be another non-invasive tool for determining whether non-obese NAFLD patients with t2DM are at risk of developing liver steatosis and fibrosis.

摘要

背景

预后考量包括评估非酒精性脂肪性肝病(NAFLD)患者的肝纤维化风险。

目的

本研究评估血液学和代谢参数在非肥胖2型糖尿病(T2DM)合并NAFLD患者中对于肝脏脂肪变性和纤维化评分(FLI和Fib-4)的应用。

方法

受试者接受腹部超声检查,并计算FLI和Fib-4评分以非侵入性评估肝脏脂肪变性和肝纤维化风险:61名非肥胖的T2DM合并NAFLD受试者纳入队列研究,并根据T2DM治疗方案分为两组。

结果

Fib-4与白细胞计数呈显著负相关(OR = 0.509,p = 0.007)。白细胞计数的R2为0.237,表明该标志物可解释Fib-4高达23.7%的变化。Fib-4与游离脂肪酸呈正相关,但未达到统计学显著预测水平(OR = 7.122,p = 0.062)。此外,还发现糖化血红蛋白(OR = 1.536,p = 0.016)和血红蛋白(OR = 1.071,p = 0.020)对FLI有显著预测作用。

结论

糖化血红蛋白以及其他血液学和代谢参数,如血红蛋白和白细胞,可能是另一种用于确定非肥胖的T2DM合并NAFLD患者是否有发生肝脏脂肪变性和纤维化风险的非侵入性工具。

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