Kakisaka Keisuke, Watanabe Takuya, Yoshida Yuichi, Abe Hiroaki, Yusa Kenji, Sasaki Tokio, Fujiwara Yudai, Abe Tamami, Suzuki Akiko, Endo Kei, Oikawa Takayoshi, Sawara Kei, Miyasaka Akio, Kuroda Hidekatsu, Matsumoto Takayuki
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan.
Hepatol Res. 2024 Oct 22. doi: 10.1111/hepr.14128.
Steatotic liver disease, characterized by a combination of metabolic dysfunction, alcohol use, or specific etiologies, is a leading cause of chronic liver disease. However, the role of metabolic dysfunction in chronic liver disease with harmful alcohol use remains unclear. This study aimed to investigate factors associated with hepatic steatosis and fibrosis in patients with harmful alcohol use.
Over a 2-year period, we registered patients with harmful alcohol use, defined by an Alcohol Use Disorders Identification Test score of 8 or higher. We retrospectively analyzed background information, blood test results, ultrasound-guided attenuation parameter (attenuation coefficient), and liver stiffness measurement. Hepatic steatosis was defined as attenuation coefficient ≥0.65 dB/cm/MHz, and fibrosis as liver stiffness measurement ≥7.5 kPa.
The study included 131 patients (82% men, median age 59 years). Linear regression analysis revealed significant associations with attenuation coefficient for body mass index ≥23 (0.08, p < 0.0001) and age (-0.002, p = 0.002). Liver stiffness measurement was associated with body mass index ≥23 (2.52, p = 0.001), aspartate aminotransferase (0.02, p = 0.0189), gamma-glutamyl transpeptidase (0.008, p < 0.0001), platelet count (-0.02, p = 0.001), and prothrombin international normalized ratio (26.40, p < 0.0001). Among the four groups classified by the presence or absence of steatosis and fibrosis, patients with fibrosis, but without steatosis, demonstrated the lowest liver reserve. In contrast, patients with both steatosis and fibrosis showed higher aspartate aminotransferase and gamma-glutamyl transpeptidase levels.
Body mass index is associated with both hepatic steatosis and fibrosis in patients with harmful alcohol use.
脂肪性肝病以代谢功能障碍、饮酒或特定病因共同存在为特征，是慢性肝病的主要病因。然而，代谢功能障碍在有害饮酒所致慢性肝病中的作用仍不明确。本研究旨在调查有害饮酒患者肝脂肪变性和肝纤维化的相关因素。
在2年期间，我们纳入了酒精使用障碍识别测试评分≥8分定义的有害饮酒患者。我们回顾性分析了背景信息、血液检查结果、超声引导下的衰减参数（衰减系数）和肝脏硬度测量值。肝脂肪变性定义为衰减系数≥0.65dB/cm/MHz，肝纤维化定义为肝脏硬度测量值≥7.5kPa。
该研究纳入了131例患者（82%为男性，中位年龄59岁）。线性回归分析显示，体重指数≥23（0.08，p<0.0001）和年龄（-0.002，p=0.002）与衰减系数显著相关。肝脏硬度测量值与体重指数≥23（2.52，p=0.001）、天冬氨酸转氨酶（0.02，p=0.0189）、γ-谷氨酰转肽酶（0.008，p<0.0001）、血小板计数（-0.02，p=0.001）和凝血酶原国际标准化比值（26.40，p<0.0001）相关。在根据脂肪变性和纤维化的有无分类的四组中，有纤维化但无脂肪变性的患者肝脏储备最低。相反，既有脂肪变性又有纤维化的患者天冬氨酸转氨酶和γ-谷氨酰转肽酶水平较高。
体重指数与有害饮酒患者的肝脂肪变性和肝纤维化均相关。
