Roesch-Dietlen F, Pérez-Morales A G, Grube-Pagola P, González-Santes M, Díaz-Roesch F, Triana-Romero A, Roesch-Ramos L, Remes-Troche J M, Cruz-Aguilar M
Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Mexico.
Profesor de la Facultad de Medicina y Vicerrector, Universidad Veracruzana, Región Veracruz-Boca del Río, Mexico.
Rev Gastroenterol Mex (Engl Ed). 2023 Jul-Sep;88(3):225-231. doi: 10.1016/j.rgmxen.2021.09.006. Epub 2023 May 29.
Metabolic (dysfunction) associated fatty liver disease (MAFLD) and gallstone disease are entities that share similar risk factors. Numerous publications confirm their elevated frequency, but few studies have considered their prevalence and possible association.
To determine the prevalence of MAFLD in patients with gallstone disease and the usefulness of liver biopsy for diagnosing the liver disease.
A prospective study was conducted on patients that underwent laparoscopic cholecystectomy, in whom liver biopsy was performed.
Anthropometric characteristics, biochemical profile, conventional ultrasound, risk factors, and histopathologic study of the liver biopsy.
Descriptive statistics were carried out for the quantitative variables and the Student's t test and multivariate analysis through binary logistic regression were employed for the continuous variables, utilizing IBM-SPSS, 25.0 (Windows) software.
A total of 136 patients were classified into 2 groups: 40 (29.41%) with normal liver and 96 (70.59%) with MAFLD. Of the 136 patients, 71 patients (52.21%) corresponded to hepatic steatosis, 21 (15.44%) to steatohepatitis, and 4 (2.94%) to cirrhosis. Perisinusoidal inflammation was found in 39 cases (28.68%) and fibrosis was found in 10 (7.35%). The risk factors for both groups were age, diabetes, high blood pressure, and obesity. Glucose, triglyceride, and aminotransferase levels were significantly higher in the MAFLD group and conventional ultrasound demonstrated moderate concordance for its detection.
The results confirmed the elevated frequency of MAFLD associated with gallstone disease, justifying liver biopsy during cholecystectomy for diagnosing MAFLD.
代谢（功能障碍）相关脂肪性肝病（MAFLD）和胆结石病是具有相似危险因素的病症。众多出版物证实了它们的高发性，但很少有研究考虑过它们的患病率及可能的关联。
确定胆结石病患者中MAFLD的患病率以及肝活检对诊断肝病的有用性。
对接受腹腔镜胆囊切除术并行肝活检的患者进行了一项前瞻性研究。
人体测量学特征、生化指标、常规超声、危险因素以及肝活检的组织病理学研究。
对定量变量进行描述性统计，对连续变量采用学生t检验，并通过二元逻辑回归进行多变量分析，使用IBM-SPSS 25.0（Windows）软件。
总共136例患者分为两组：40例（29.41%）肝脏正常，96例（70.59%）患有MAFLD。在这136例患者中，71例（52.21%）为肝脂肪变性，21例（15.44%）为脂肪性肝炎，4例（2.94%）为肝硬化。39例（28.68%）发现有窦周炎症，10例（7.35%）发现有纤维化。两组的危险因素均为年龄、糖尿病、高血压和肥胖。MAFLD组的血糖、甘油三酯和转氨酶水平显著更高，常规超声对其检测显示出中度一致性。
结果证实了与胆结石病相关的MAFLD的高发性，证明在胆囊切除术中进行肝活检以诊断MAFLD是合理的。
