与瘦代谢功能障碍相关的脂肪肝相比,重度肥胖的预后更差。

IF 5.6 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatology Communications Pub Date : 2024-06-27 eCollection Date: 2024-07-01 DOI:10.1097/HC9.0000000000000471
Jaideep Behari, Renwei Wang, Hung N Luu, David McKenzie, Michele Molinari, Jian-Min Yuan
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引用次数: 0

摘要

背景:代谢功能障碍相关性脂肪性肝病(MASLD)在肥胖症患者中发病率很高。我们的目的是研究体重指数(BMI)与 MASLD 患者临床预后的关系:方法:通过美国一家大型医疗系统的电子健康记录中的国际疾病分类-9 和 10 代码,对 32,900 名 MASLD 患者进行回顾性队列研究,将其分为 6 个 BMI 类别,平均随访 5.5 年(范围:1-15 年):肝脏失代偿和肝外肥胖相关癌症的风险呈 "J "形分布(线性和二次项的Ps均为结论):MASLD和极重度肥胖(BMI≥50 kg/m2)患者发生肝脏失代偿、肥胖相关肝外癌症或死于任何原因的风险最高,超过了瘦MASLD患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Severe obesity is associated with worse outcomes than lean metabolic dysfunction-associated steatotic liver disease.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in people with obesity. We aimed to study the association of body mass index (BMI) with clinical outcomes in patients with MASLD.

Methods: A retrospective cohort of 32,900 patients with MASLD, identified through the International Classification of Diseases-9 and 10 codes within the electronic health records of a large US-based health system, with a mean follow-up of 5.5 years (range: 1-15 y), was stratified into 6 BMI categories, <25, 25-<30, 30-<40, 40-<50, and ≥50 kg/m2.

Results: The risk of liver decompensation and extrahepatic obesity-associated cancers had a J-shaped profile (both ps for linear and quadratic terms <0.05). Compared to patients with BMI 25-<30 kg/m2, the adjusted HRs (95% CIs) for liver decompensation of patients with BMI <25 and BMI ≥50 kg/m2 were 1.44 (1.17-1.77) and 2.27 (1.66-3.00), respectively. The corresponding figures for obesity-associated extrahepatic cancer were 1.15 (0.97-1.36) and 1.29 (1.00-1.76). There was an inverse association for BMI with liver transplantation and non-obesity-associated cancer (both ps for linear terms <0.05), but no association with HCC or all types of cancers combined. A similar J-shaped association between BMI and all-cause mortality was observed; adjusted HRs (95% CIs) for BMI <25 and ≥50 kg/m2 were 1.51 (1.32-1.72) and 3.24 (2.67-3.83), respectively, compared with BMI 25-<30 kg/m2 (both ps for linear and quadratic terms <0.001).

Conclusions: Patients with MASLD and very severe obesity (BMI ≥50 kg/m2) had the highest risk, exceeding that of patients with lean MASLD, for developing liver decompensation, obesity-associated extrahepatic cancers, or dying from any cause.

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来源期刊
Hepatology Communications
Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
8.00
自引率
2.00%
发文量
248
审稿时长
8 weeks
期刊介绍: Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction. ​
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