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普通人群脂肪性肝病筛查的可持续性:一项概念验证研究。

Sustainability of General Population Screening for Steatotic Liver Disease: A Proof-of-Concept Study.

作者信息

De Rosa Laura, Ricco Gabriele, Brunetto Maurizia Rossana, Bonino Ferruccio, Faita Francesco

机构信息

Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy.

Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Centre of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa (AOUP), 56124 Pisa, Italy.

出版信息

Healthcare (Basel). 2025 Mar 28;13(7):759. doi: 10.3390/healthcare13070759.

Abstract

BACKGROUND

Steatotic liver disease (SLD) is a growing global health concern and may progress to more advanced liver diseases (i.e., fibrosis, cirrhosis, and hepatocellular carcinoma). Early identification of individuals at risk through effective screening strategies is crucial for timely intervention and management. The aim of this population-based study was to evaluate the feasibility of mean/large-scale screening and its importance by analyzing key risk factors, such as metabolic and lifestyle-related determinants.

METHODS

This cross-sectional study involved 387 subjects aged 18 to 89 years in a remote rural area that stretches among the valleys at the foot of the Apennines and the Apuan Alps. Anthropometric and demographic data were recorded, together with the measurement of blood pressure and cardiac rhythm. Furthermore, US-based liver stiffness (LS) and the ultrasound attenuation parameter (UAP) using the ILivTouch (Hisky Medical, Wuxi, China) device were performed. All data were analyzed with SPSS version 28. Univariate and multivariate analyses were conducted to identify significant predictors of both LS and UAP.

RESULTS

Significant associations are observed between elevated LS and UAP values and risk factors, such as BMI and waist circumference (BMI and waist with R = 0.45 and R = 0.34, R = 0.29 and R = 0.28; respectively, for UAP and LS; all with < 0.001). The presence of hypertension is associated with a high value of LS ( < 0.05), and high UAP with alcohol consumption and sugary coffee intake habit ( < 0.001 and, < 0.05, respectively).

CONCLUSIONS

General population screening for SLD is feasible, sustainable, and useful to identify both individuals at risk and patients with progressive liver disease.

摘要

背景

脂肪性肝病(SLD)是一个日益引起全球关注的健康问题,可能会发展为更严重的肝脏疾病(即纤维化、肝硬化和肝细胞癌)。通过有效的筛查策略早期识别高危个体对于及时干预和管理至关重要。这项基于人群的研究旨在通过分析关键风险因素,如代谢和生活方式相关决定因素,评估平均/大规模筛查的可行性及其重要性。

方法

这项横断面研究涉及387名年龄在18至89岁之间的受试者,他们来自亚平宁山脉和阿普安阿尔卑斯山脚下山谷间的一个偏远农村地区。记录了人体测量和人口统计学数据,以及血压和心律测量值。此外,使用ILivTouch(中国无锡海斯凯医疗)设备进行了基于超声的肝脏硬度(LS)和超声衰减参数(UAP)测量。所有数据均使用SPSS 28版进行分析。进行单变量和多变量分析以确定LS和UAP的显著预测因素。

结果

观察到LS和UAP值升高与风险因素之间存在显著关联,如体重指数(BMI)和腰围(对于UAP和LS,BMI和腰围的相关系数R分别为0.45和0.34、0.29和0.28;均P<0.001)。高血压的存在与高LS值相关(P<0.05),高UAP与饮酒和含糖咖啡摄入习惯相关(分别为P<0.001和P<0.05)。

结论

对普通人群进行SLD筛查是可行的、可持续的,并且有助于识别高危个体和患有进展性肝病的患者。

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