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肌肉减少性肥胖在代谢功能障碍相关脂肪性肝病(MASLD)患者中的临床相关性

Clinical Relevancies of Sarcopenic Obesity in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease (MASLD).

作者信息

Chien Shih-Chieh, Chiu Hung-Chih, Chiu Yen-Cheng, Wang Ru-Hsueh, Dillera Karl Paolo O, Lee Kuo-Ting, Tsai Hung-Wen, Tsai Yau-Sheng, Ou Horng-Yih, Cheng Pin-Nan

机构信息

Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 70401, Taiwan.

Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70401, Taiwan.

出版信息

Dig Dis Sci. 2025 Mar;70(3):1190-1200. doi: 10.1007/s10620-025-08844-z. Epub 2025 Jan 18.

Abstract

AIM

Sarcopenic obesity (SO) is associated with adverse outcomes in diseased patients. This study aimed to examine the prevalence and risks associated with SO, with a focus on the impact of SO on cardiovascular risk in patients with MASLD.

MATERIALS AND METHODS

In this cross-sectional study, patients with MASLD were prospectively enrolled. Through dual-energy X-ray absorptiometry (DXA) scans, their body compositions were analyzed to identify who had SO and osteopenia/osteoporosis. The primary aim is to investigate risks associated with SO, followed by analyzing the association between SO and cardiovascular disease (CVD).

RESULTS

Two hundred and twenty-three patients with MASLD were enrolled. The prevalence of SO was 47.1%, respectively. Patients coexisted with MASLD and SO had increased visceral adipose tissue (VAT), higher fatty liver index (FLI) and fibrosis 4 (FIB-4) score. Regression analysis revealed higher FLI and FIB-4 score, as well as history of hypertension, were risks associated with SO. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score was higher in patients coexisted with MASLD and SO compared to those without (10.1% vs. 7.3%, p = 0.006). Regression analysis showed that increased VAT and FIB-4 score were associated with raised risk of ASCVD.

CONCLUSION

Prevalence of SO in MASLD patients is considerable. The presence of SO also linked to higher risk of ASCVD. Therefore, the recognition of SO in patients with MASLD is important in clinical care.

摘要

目的

肌少症性肥胖(SO)与患病患者的不良结局相关。本研究旨在调查SO的患病率及其相关风险,重点关注SO对非酒精性脂肪性肝病(MASLD)患者心血管风险的影响。

材料与方法

在这项横断面研究中,前瞻性纳入了MASLD患者。通过双能X线吸收法(DXA)扫描分析他们的身体成分,以确定哪些人患有SO和骨质减少/骨质疏松症。主要目的是调查与SO相关的风险,随后分析SO与心血管疾病(CVD)之间的关联。

结果

共纳入223例MASLD患者。SO的患病率分别为47.1%。同时患有MASLD和SO的患者内脏脂肪组织(VAT)增加,脂肪肝指数(FLI)和纤维化4(FIB-4)评分更高。回归分析显示,较高的FLI和FIB-4评分以及高血压病史是与SO相关的风险因素。与未患SO的患者相比,同时患有MASLD和SO的患者的10年动脉粥样硬化性心血管疾病(ASCVD)风险评分更高(10.1%对7.3%,p = 0.006)。回归分析表明,VAT增加和FIB-4评分升高与ASCVD风险增加相关。

结论

MASLD患者中SO的患病率相当高。SO的存在也与更高的ASCVD风险相关。因此,在临床护理中识别MASLD患者中的SO很重要。

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