降脂治疗对家族性高胆固醇血症患者 MASLD 指数的影响。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2024-10-16 DOI:10.1016/j.clnu.2024.10.020

Chrysoula Boutari , Christos V. Rizos , George Liamis , Ioannis Skoumas , Loukianos Rallidis , Anastasia Garoufi , Genovefa Kolovou , George Sfikas , Konstantinos Tziomalos , Emmanouil Skalidis , Vasileios Kotsis , Michalis Doumas , Kimon Stamatelopoulos , Vaia Lambadiari , Panagiotis Anagnostis , Amalia Boufidou , Vasiliki Giannakopoulou , Georgia Anastasiou , Ermioni Petkou , Charalambos Vlachopoulos , Christos S. Mantzoros

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引用次数: 0

摘要

背景与目的：降脂治疗（LLT）对代谢功能障碍相关性脂肪性肝病（MASLD）的影响尚不明确。这与终身接受降脂治疗的家族性高胆固醇血症（FH）患者有关。我们的目的是评估 LLT 对该人群 MASLD 指数的影响：希腊高胆固醇血症登记处（HELLAS-FH）纳入了至少可能诊断为高胆固醇血症的患者。我们分析了他汀类药物单一疗法、他汀类药物/埃塞替米贝和他汀类药物/埃塞替米贝/丙蛋白转换酶亚基酶/kexin 9抑制剂（PCSK9i）对MASLD指数（即原始甘油三酯-葡萄糖指数（TyGO）和甘油三酯-葡萄糖指数（TyG））的影响。我们比较了TyG和TyGO在任何治疗前和至少一年稳定LLT后的变化：我们纳入了 1289 名患者：他汀类药物单一疗法组 569 人（平均年龄为 51 ± 15 岁，52.7% 为男性），他汀类药物/依折麦布组 629 人（52 ± 14 岁，51.8%），他汀类药物/依折麦布/PCSK9i 组 91 人（54 ± 13 岁，58.2%）。与基线相比，他汀类药物单药治疗后，TyGO 和 TyG 显著下降（分别为 8.61 vs 8.49 和 4.65 vs 4.59，均为 p 结论：他汀类药物/依折麦布/PCSK9i 组的 MASLD 指数均显著改善：FH患者所有LLT组的MASLD指数均有明显改善。与他汀类药物单药治疗相比，他汀类药物/埃塞替米贝和他汀类药物/埃塞替米贝/PCSK9i与TyGO定义的MASLD缓解程度更大相关。

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The effect of lipid-lowering treatment on indices of MASLD in familial hypercholesterolemia patients

Background & aims

The effect of lipid-lowering treatment (LLT) on metabolic dysfunction associated steatotic liver disease (MASLD) is unclear. This is relevant for patients with familial hypercholesterolemia (FH) who are on lifelong LLT. We aimed to evaluate the effect of LLT on MASLD indices in this population.

Methods

Patients with at least possible diagnosis of FH were included into the Hellenic FH Registry (HELLAS-FH) registry. We analyzed the effect of statin monotherapy, statin/ezetimibe and statin/ezetimibe/proprotein convertase subtilisin/kexin 9 inhibitors (PCSK9i) on MASLD indices, i.e., original triglyceride-glucose index (TyGO) and triglyceride-glucose index (TyG). We compared changes of TyG and TyGO before any treatment and after at least one year of stable LLT.

Results

We included 1289 patients: n = 569 in the statin monotherapy group (mean age = 51 ± 15 years, 52.7 % males), n = 629 in the statin/ezetimibe group (52 ± 14 years, 51.8 %), and n = 91 in the statin/ezetimibe/PCSK9i group (54 ± 13 years, 58.2 %). Compared with baseline, TyGO and TyG decreased significantly following statin monotherapy (8.61 vs 8.49 and 4.65 vs 4.59, respectively, both p < 0.01), statin/ezetimibe (8.59 vs 8.41 and 4.64 vs 4.55, respectively, both p < 0.01) and statin/ezetimibe/PCSK9i (8.79 vs 8.55 and 4.74 vs 4.62, respectively, both p < 0.01). There was no difference regarding the change of TyGO and TyG between groups after adjusting for baseline levels. A greater percentage of patients in the statin/ezetimibe and statin/ezetimibe/PCSK9i groups exhibited TyGO-defined MASLD resolution compared with statin monotherapy (p < 0.05). After adjustment for possible confounders, LLT was significantly associated with MASLD resolution.

Conclusions

MASLD indices were significantly improved in all LLT groups in FH patients. Statin/ezetimibe and statin/ezetimibe/PCSK9i were associated with greater TyGO-defined MASLD resolution compared with statin monotherapy.

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.