代谢功能障碍相关脂肪性肝病已确诊和未确诊患者的临床和生化特征
Clinical and Biochemical Features of Diagnosed and Undiagnosed Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease.
作者信息
Minuk Gerald Yosel, Baseri Mona, Bakalets Eleonora, Zhang Manna, Uhanova Julia
机构信息
The Section of Hepatology, Department of Medicine, Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
出版信息
Can Liver J. 2025 Mar 28;8(2):322-328. doi: 10.3138/canlivj-2025-0053. eCollection 2025 May.
BACKGROUND
The majority of the world's metabolic dysfunction-associated steatotic liver disease (MASLD) patient population remain undiagnosed. Whether the clinical and biochemical features of these individuals resemble those with an established diagnosis of MASLD remains to be determined. The aim of this study was to document and compare the demographics, associated metabolic comorbidities, liver biochemistry, and non-invasive markers of hepatic fibrosis and portal hypertension in diagnosed versus undiagnosed MASLD patients.
METHODS
The two study cohorts consisted of 3,101 MASLD patients attending a tertiary care centre (diagnosed) and 408 individuals with MASLD identified as a result of volunteering in a community-based MASLD screening clinic (undiagnosed).
RESULTS
Diagnosed MASLD patients were younger (51±14 vs. 54±13 years, <0.00001), more often male (50% vs. 34%, <0.00001), and diabetic (40% vs. 17%, <0.00001) but less often dyslipidemic (29% vs. 46%, <0.00001). BMIs were similar in the two cohorts. The prevalence and extent of liver transaminases (ALT and AST) and function test (albumin, bilirubin, and INR values) abnormalities were greater in diagnosed MASLD patients as were non-invasive determinants of hepatic fibrosis and portal hypertension (higher FIB-4 values and lower platelet counts, respectively).
CONCLUSIONS
The demographics, metabolic co-morbidities, and severity of liver disease differ in diagnosed versus undiagnosed MASLD patients.
背景
世界上大多数代谢功能障碍相关脂肪性肝病（MASLD）患者仍未被诊断出来。这些个体的临床和生化特征是否与已确诊的MASLD患者相似，仍有待确定。本研究的目的是记录和比较已确诊与未确诊的MASLD患者的人口统计学特征、相关代谢合并症、肝脏生化指标以及肝纤维化和门静脉高压的非侵入性标志物。
方法
两个研究队列包括3101名在三级医疗中心就诊的MASLD患者（已确诊）和408名因参与社区MASLD筛查诊所志愿者活动而被确诊为MASLD的个体（未确诊）。
结果
已确诊的MASLD患者更年轻（51±14岁对54±13岁，<0.00001），男性比例更高（50%对34%，<0.00001），糖尿病患者比例更高（40%对17%，<0.00001），但血脂异常患者比例更低（29%对46%，<0.00001）。两个队列的体重指数相似。已确诊的MASLD患者肝转氨酶（ALT和AST）和肝功能检查（白蛋白、胆红素和INR值）异常的患病率和程度更高，肝纤维化和门静脉高压的非侵入性决定因素也是如此（分别为更高的FIB-4值和更低的血小板计数）。
结论
已确诊与未确诊的MASLD患者在人口统计学特征、代谢合并症和肝病严重程度方面存在差异。
Zotero 插件