代谢功能障碍相关脂肪变性肝病患者肌肉减少症与肝纤维化进展的相关性:一项来自中国和美国两个队列的研究

IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS
Fan Zhang, Longgen Liu, Wenjian Li
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引用次数: 0

摘要

目的:本研究的目的是调查18-59岁代谢功能障碍相关脂肪变性肝病(MASLD)患者肌肉减少症与肝纤维化之间的关系,并评估肌肉减少症作为肝纤维化进展的危险因素的潜力。方法:该研究纳入美国队列821例MASLD患者和中国队列3405例MASLD患者。通过振动控制瞬时弹性成像(VCTE)评估肝控制衰减参数(CAP)和肝刚度测量(LSM),以评估肝脂肪变性和纤维化的程度。通过测量阑尾骨骼肌质量(ASM)和计算ASMI来评估肌肉减少症。为了分析肌肉减少症、ASMI和肝纤维化之间的关系,采用logistic回归模型、多变量调整模型和限制性三次样条(RCS)模型,并进行分层和相互作用分析。结果:结果表明,在两个队列中,与没有肌肉减少症的患者相比,肌肉减少症患者出现显著肝纤维化、晚期肝纤维化和肝硬化的风险明显升高。在调整混杂变量后,肌少症被确定为MASLD患者肝纤维化进展的独立危险因素。ASMI与肝纤维化严重程度呈显著负相关,随着ASMI的增加,肝纤维化风险逐渐降低。此外,一些肝纤维化指标具有明显的非线性特征。亚组分析进一步证实了肌少症对肝纤维化的有害影响在所有确定的亚组中是一致的。结论:肌少症可能与MASLD患者肝纤维化的进展有关。监测ASMI可能有助于识别MASLD患者中肝纤维化风险升高的个体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlation of sarcopenia with progression of liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease: a study from two cohorts in China and the United States.

Objective: The objective of this study was to investigate the association between sarcopenia and liver fibrosis in patients aged 18-59 years with metabolic dysfunction-associated steatotic liver disease (MASLD) and to assess the potential of sarcopenia as a risk factor for the progression of liver fibrosis.

Methods: The study included 821 patients with MASLD in the US cohort and 3,405 patients with MASLD in the Chinese cohort. Liver controlled attenuation parameters (CAP) and liver stiffness measurements (LSM) were assessed by vibration-controlled transient elastography (VCTE) to evaluate the extent of hepatic steatosis and fibrosis. Sarcopenia was assessed by measuring appendicular skeletal muscle mass (ASM) and calculating ASMI. To analyze the relationship between sarcopenia, ASMI, and liver fibrosis, logistic regression models, multivariate-adjusted models, and restricted cubic spline (RCS) models were employed, with stratification and interaction analyses.

Results: The results demonstrated that patients with sarcopenia exhibited a markedly elevated risk of significant liver fibrosis, advanced liver fibrosis, and cirrhosis compared to those without sarcopenia in both cohorts. After adjusting for confounding variables, sarcopenia was identified as an independent risk factor for the progression of liver fibrosis in patients with MASLD. A significant negative correlation was observed between ASMI and the severity of liver fibrosis, with a progressive reduction in the risk of liver fibrosis associated with increasing ASMI. Additionally, a non-linear feature was evident in some liver fibrosis indicators. Subgroup analysis further corroborated the finding that the harmful effect of sarcopenia on liver fibrosis was consistent across all identified subgroups.

Conclusion: Sarcopenia may be associated with the progression of liver fibrosis in patients with MASLD. Monitoring ASMI may assist in identifying individuals at an elevated risk of liver fibrosis in MASLD patients.

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来源期刊
Nutrition Journal
Nutrition Journal NUTRITION & DIETETICS-
CiteScore
9.80
自引率
0.00%
发文量
68
审稿时长
4-8 weeks
期刊介绍: Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
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