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腹腔镜袖状胃切除术患者脂肪肝疾病分级与围手术期危险因素的比较

Comparison of the Grades of Fatty Liver Disease With Perioperative Risk Factors in Patients With Laparoscopic Sleeve Gastrectomy.

作者信息

Kara Yalçın Burak, Ozel Yahya

机构信息

Department of General Surgery, Bahcesehir University, School of Medicine, Istanbul, TUR.

Department of General Surgery, Medical Park Pendik Hospital, Istanbul, TUR.

出版信息

Cureus. 2024 Sep 19;16(9):e69717. doi: 10.7759/cureus.69717. eCollection 2024 Sep.

Abstract

Background Obesity is a global healthcare problem, and nonalcoholic fatty liver disease (NAFLD) is a commonly observed comorbid disease in the bariatric population. This study evaluated the relationship between NAFLD and various risk factors, including demographic, biochemical, and comorbid conditions in patients undergoing laparoscopic sleeve gastrectomy (LSG). Material and methods This retrospective data analysis study included patients who underwent LSG between August 2023 and 2024. Patient demographic data were collected, such as age, gender, weight, and body mass index (BMI), and NAFLD grade was determined by ultrasonography. Biochemical markers were recorded, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), fasting blood glucose (FBG), HbA1c, and vitamin D. The presence of type II diabetes mellitus (T2DM) and hypertension (HT) was evaluated and compared with the grade of hepatosteatosis. Results The study included 436 patients, of whom 73.6% ( = 321) were female. The mean age was 37.23 ± 10.49 years, and the mean BMI value was 41.25 ± 6.11 kg/m. Patients were classified and compared according to their NAFLD grade, revealing statistically significant differences in weight, BMI, ALT, AST, HDL, LDL, TG, total cholesterol, HbA1c, FBG, vitamin D, obesity class, DM, and HT ( 005). HDL and vitamin D showed an inverse correlation with NAFLD. We observed no significant difference in the relationship of NAFLD with age and the presence of gallstone. Logistic regression analysis revealed that ALT, AST, LDL, total cholesterol, and FBG were statistically significantly associated with NAFLD in the multivariate model. Conclusion Hepatosteatosis, T2DM, and HT are frequent comorbid diseases that are common in bariatric patients. Our study shows that ALT, AST, LDL, FBG, and total cholesterol may be used as predictors of NAFLD.

摘要

背景

肥胖是一个全球性的医疗保健问题,非酒精性脂肪性肝病(NAFLD)是肥胖人群中常见的合并症。本研究评估了接受腹腔镜袖状胃切除术(LSG)患者的NAFLD与各种风险因素之间的关系,这些因素包括人口统计学、生化指标和合并症。

材料与方法

这项回顾性数据分析研究纳入了2023年8月至2024年期间接受LSG的患者。收集患者的人口统计学数据,如年龄、性别、体重和体重指数(BMI),并通过超声检查确定NAFLD分级。记录生化指标,包括丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆固醇、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)和维生素D。评估II型糖尿病(T2DM)和高血压(HT)的存在情况,并与肝脂肪变性分级进行比较。

结果

该研究纳入了436例患者,其中73.6%(n = 321)为女性。平均年龄为37.23±10.49岁,平均BMI值为41.25±6.11kg/m²。根据NAFLD分级对患者进行分类和比较,结果显示体重、BMI、ALT、AST、HDL、LDL、TG、总胆固醇、HbA1c、FBG、维生素D、肥胖类别、糖尿病和高血压存在统计学显著差异(P < 0.05)。HDL和维生素D与NAFLD呈负相关。我们观察到NAFLD与年龄及胆结石存在情况之间的关系无显著差异。逻辑回归分析显示,在多变量模型中,ALT、AST、LDL、总胆固醇和FBG与NAFLD在统计学上显著相关。

结论

肝脂肪变性、T2DM和HT是肥胖症患者常见的合并症。我们的研究表明,ALT、AST、LDL、FBG和总胆固醇可作为NAFLD的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8ca/11490200/13a9128e5370/cureus-0016-00000069717-i01.jpg

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