病毒根除后慢性丙型肝炎患者 MASLD 的动态变化:台湾一项全国性登记研究。

IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Molecular Hepatology Pub Date : 2024-10-01 Epub Date: 2024-07-29 DOI:10.3350/cmh.2024.0414
Chung-Feng Huang, Chia-Yen Dai, Yi-Hung Lin, Chih-Wen Wang, Tyng-Yuan Jang, Po-Cheng Liang, Tzu-Chun Lin, Pei-Chien Tsai, Yu-Ju Wei, Ming-Lun Yeh, Ming-Yen Hsieh, Chao-Kuan Huang, Jee-Fu Huang, Wan-Long Chuang, Ming-Lung Yu
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引用次数: 0

摘要

背景/目的:脂肪肝(SLD)是慢性丙型肝炎(CHC)的常见表现。CHC 的代谢改变与代谢功能障碍相关性脂肪性肝病(MASLD)有关。我们旨在阐明根除丙型肝炎病毒(HCV)是否会减轻或缓解 MASLD 的发生:我们在全国范围内的 HCV 登记处登记了 5,840 名通过直接作用抗病毒药物根除 HCV 的 CHC 患者。在基线和 HCV 治愈后 6 个月对 MASLD 和相关的心脏代谢风险因素(CMRFs)进行了评估:共有 2,147 例(36.8%)SLD 患者,其中 1,986 例(34.0%)在治疗前符合 MASLD 标准。治疗后,HbA1C(6.0% 对 5.9%,PConclusions:根除 HCV 可减轻 CHC 患者的 MASLD。对于有代谢改变的 CHC 患者,CMRF 监测是必须的,这些代谢改变在根除 HCV 后会发生改变,并预测 MASLD 的演变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dynamic change of metabolic dysfunction-associated steatotic liver disease in chronic hepatitis C patients after viral eradication: A nationwide registry study in Taiwan.

Background/aims: Steatotic liver disease (SLD) is a common manifestation in chronic hepatitis C (CHC). Metabolic alterations in CHC are associated with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to elucidate whether hepatitis C virus (HCV) eradication mitigates MASLD occurrence or resolution.

Methods: We enrolled 5,840 CHC patients whose HCV was eradicated by direct-acting antivirals in a nationwide HCV registry. MASLD and the associated cardiometabolic risk factors (CMRFs) were evaluated at baseline and 6 months after HCV cure.

Results: There were 2,147 (36.8%) patients with SLD, and 1,986 (34.0%) of them met the MASLD criteria before treatment. After treatment, HbA1c (6.0% vs. 5.9%, P<0.001) and BMI (24.8 kg/m2 vs. 24.7 kg/m2, P<0.001) decreased, whereas HDL-C (49.1 mg/dL vs. 51.9 mg/dL, P<0.001) and triglycerides (102.8 mg/dL vs. 111.9 mg/dL, P<0.001) increased significantly. The proportion of patients with SLD was 37.5% after HCV eradication, which did not change significantly compared with the pretreatment status. The percentage of the patients who had post-treatment MASLD was 34.8%, which did not differ significantly from the pretreatment status (P=0.17). Body mass index (BMI) (odds ratio [OR] 0.89; 95% confidence intervals [CI] 0.85-0.92; P<0.001) was the only factor associated with MASLD resolution. In contrast, unfavorable CMRFs, including BMI (OR 1.10; 95% CI 1.06-1.14; P<0.001) and HbA1c (OR 1.19; 95% CI 1.04-1.35; P=0.01), were independently associated with MASLD development after HCV cure.

Conclusion: HCV eradication mitigates MASLD in CHC patients. CMRF surveillance is mandatory for CHC patients with metabolic alterations, which are altered after HCV eradication and predict the evolution of MASLD.

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来源期刊
Clinical and Molecular Hepatology
Clinical and Molecular Hepatology Medicine-Hepatology
CiteScore
15.60
自引率
9.00%
发文量
89
审稿时长
10 weeks
期刊介绍: Clinical and Molecular Hepatology is an internationally recognized, peer-reviewed, open-access journal published quarterly in English. Its mission is to disseminate cutting-edge knowledge, trends, and insights into hepatobiliary diseases, fostering an inclusive academic platform for robust debate and discussion among clinical practitioners, translational researchers, and basic scientists. With a multidisciplinary approach, the journal strives to enhance public health, particularly in the resource-limited Asia-Pacific region, which faces significant challenges such as high prevalence of B viral infection and hepatocellular carcinoma. Furthermore, Clinical and Molecular Hepatology prioritizes epidemiological studies of hepatobiliary diseases across diverse regions including East Asia, North Asia, Southeast Asia, Central Asia, South Asia, Southwest Asia, Pacific, Africa, Central Europe, Eastern Europe, Central America, and South America. The journal publishes a wide range of content, including original research papers, meta-analyses, letters to the editor, case reports, reviews, guidelines, editorials, and liver images and pathology, encompassing all facets of hepatology.
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