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考虑到临床实践中随时间变化使用的不同定义,对代谢综合征及其各个组成部分的肝脏脂肪变性和纤维化风险进行评估:一项回顾性横断面研究。

Assessment of the Liver Steatosis and Fibrosis Risk in Metabolic Syndrome and Its Individual Components, Considering the Varying Definitions Used in Clinical Practice throughout Time: A Retrospective Cross-Sectional Study.

作者信息

Suwała Szymon, Junik Roman

机构信息

Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland.

出版信息

Biomedicines. 2024 Aug 2;12(8):1739. doi: 10.3390/biomedicines12081739.

Abstract

Multiple modifications of metabolic syndrome diagnostic criteria have been made-NCEP: ATP III (from 2001, modified in 2004), IDF (2005), IDF Consortium (2009), or Polish Scientific Society Consortium standards (2022) are now frequently in use. Hepatosteatosis and hepatofibrosis are commonly mentioned aspects of metabolic syndrome that greatly increase the likelihood of developing complications. The objective of the study was to assess different diagnostic criteria for metabolic syndrome based on the prevalence of liver steatosis and fibrosis. A retrospective analysis was conducted on the medical data of 2102 patients. Out of all the single criteria, meeting the obesity criterion based on waist circumference showed the highest increase in the risk of hepatosteatosis (by 64-69%, depending on the definition used)-hypertriglyceridemia increased the risk of hepatofibrosis by 71%. Regardless of the specific criteria used, patients with metabolic syndrome had a 34-36% increased likelihood of developing hepatosteatosis-the probability of hepatofibrosis varied between 42% and 47% for the criteria established in 2004, 2005, and 2009, while the Polish 2022 criteria were not statistically significant ( = 0.818). It seems appropriate to establish consistent metabolic syndrome diagnostic criteria-the 2009 IDF guidelines are the most effective in assessing hepatosteatosis and fibrosis risk.

摘要

代谢综合征的诊断标准已经有了多种修订——目前常用的有美国国家胆固醇教育计划成人治疗组第三次报告(NCEP: ATP III,2001年发布,2004年修订)、国际糖尿病联盟(IDF,2005年)、IDF联盟(2009年)或波兰科学协会联盟标准(2022年)。肝脂肪变性和肝纤维化是代谢综合征中经常提到的方面,它们大大增加了发生并发症的可能性。本研究的目的是根据肝脂肪变性和纤维化的患病率评估代谢综合征的不同诊断标准。对2102例患者的医疗数据进行了回顾性分析。在所有单一标准中,基于腰围符合肥胖标准显示肝脂肪变性风险增加最高(增加64%-69%,具体取决于所使用的定义)——高甘油三酯血症使肝纤维化风险增加71%。无论使用何种具体标准,代谢综合征患者发生肝脂肪变性的可能性增加34%-36%——对于2004年、2005年和2009年制定的标准,肝纤维化的概率在42%至47%之间,而波兰2022年的标准无统计学意义(P = 0.818)。建立一致的代谢综合征诊断标准似乎是合适的——2009年IDF指南在评估肝脂肪变性和纤维化风险方面最有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f49c/11351204/82c1b951d527/biomedicines-12-01739-g001.jpg

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