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通过传统B超评估非糖尿病患者的肝脏脂肪含量及代谢状况:对临床实践的启示

Liver fat content assessed by conventional B-mode ultrasound and metabolic profile in non-diabetic patients: Implications for clinical practice.

作者信息

Villani Rosanna, Magnati Grazia Pia, Tuccari Giulia, Sangineto Moris, Romano Antonino Davide, Cassano Tommaso, Serviddio Gaetano

机构信息

C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.

Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.

出版信息

Ultrasound. 2023 Aug;31(3):177-185. doi: 10.1177/1742271X221122585. Epub 2022 Oct 3.

Abstract

INTRODUCTION

Several studies have demonstrated a positive correlation between severe hepatic steatosis and metabolic alterations; however, few studies have addressed the potential association between different grades of steatosis and clinical patterns in a non-diabetic population.

METHODS

We conducted a cross-sectional study of 223 non-diabetic individuals. The severity of steatosis was assessed using B-mode ultrasound. We analyzed lipid and glucose profiles according to the severity of hepatic steatosis. Estimated glomerular filtration rate (eGFR) values were also recorded to investigate the potential impact of steatosis on kidney function.

RESULTS

Patients with steatosis were found to have higher insulinemia and mean values of fasting plasma glucose compared to patients without steatosis. A significant decrease in high-density lipoprotein level was observed only in patients with severe or moderate steatosis. All grades of steatosis were associated with increased triglyceride levels, which were more significant in severe steatosis. Subgroup analysis by body mass index demonstrated a significant difference between lean patients with steatosis and lean patients without steatosis for triglycerides (p = 0.002) and high-density lipoprotein levels (p = 0.019). Finally, patients diagnosed with steatosis demonstrated a higher prevalence of estimated glomerular filtration rate < 90 ml/min.

CONCLUSION

The degree of steatosis diagnosed at ultrasound may predict glucose or lipid metabolism disorders and a decline in kidney function in a non-diabetic population.

摘要

引言

多项研究表明严重肝脂肪变性与代谢改变之间存在正相关;然而,很少有研究探讨非糖尿病人群中不同程度脂肪变性与临床模式之间的潜在关联。

方法

我们对223名非糖尿病个体进行了一项横断面研究。使用B型超声评估脂肪变性的严重程度。我们根据肝脂肪变性的严重程度分析了血脂和血糖谱。还记录了估计肾小球滤过率(eGFR)值,以研究脂肪变性对肾功能的潜在影响。

结果

与无脂肪变性的患者相比,发现有脂肪变性的患者胰岛素血症和空腹血糖平均值更高。仅在重度或中度脂肪变性患者中观察到高密度脂蛋白水平显著降低。所有程度的脂肪变性均与甘油三酯水平升高有关,在重度脂肪变性中更为显著。按体重指数进行的亚组分析显示,有脂肪变性的瘦患者与无脂肪变性的瘦患者在甘油三酯(p = 0.002)和高密度脂蛋白水平(p = 0.019)方面存在显著差异。最后,被诊断为脂肪变性的患者估计肾小球滤过率<90 ml/min的患病率更高。

结论

超声诊断的脂肪变性程度可能预测非糖尿病人群中的糖或脂代谢紊乱以及肾功能下降。

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Ultrasound-based techniques for the diagnosis of liver steatosis.基于超声的肝脂肪变性诊断技术。
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