预测肝活检诊断的脂肪变性肝病肝脏相关事件的临床变量

IF 1.1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Internal Medicine Pub Date : 2025-08-15 Epub Date: 2025-02-08 DOI:10.2169/internalmedicine.4770-24
Shinnosuke Okubo, Akinobu Takaki, Ikumi Sato, Takuya Adachi, Yasuto Takeuchi, Masahiko Sue, Nozomi Miyake, Hideki Onishi, Satoshi Hirohata, Motoyuki Otsuka
{"title":"预测肝活检诊断的脂肪变性肝病肝脏相关事件的临床变量","authors":"Shinnosuke Okubo, Akinobu Takaki, Ikumi Sato, Takuya Adachi, Yasuto Takeuchi, Masahiko Sue, Nozomi Miyake, Hideki Onishi, Satoshi Hirohata, Motoyuki Otsuka","doi":"10.2169/internalmedicine.4770-24","DOIUrl":null,"url":null,"abstract":"<p><p>Objective Identifying patients at high risk of steatotic liver disease (SLD) is crucial. The liver fibrosis stage is the most reliable marker of liver-related mortality. However, non-invasive risk stratification methods remain controversial. Therefore, we analyzed the risk of liver-related events in patients who underwent a liver biopsy for metabolic dysfunction-associated steatotic liver disease (MASLD) or cryptogenic SLD at our hospital. Methods We retrospectively reviewed the clinical course of the patients to identify the occurrence of liver-related events. Patients This study included 146 patients diagnosed with SLD through a liver biopsy. Results Liver-related events occurred in 20 patients and were more frequent in those with advanced fibrosis than in those without advanced fibrosis. However, patients with advanced steatosis exhibit reduced disease progression. Patients with obesity and/or diabetes complications had a lower stage of fibrosis and better prognosis than the others. The non-invasive fibrosis-4 (FIB-4) index and non-alcoholic fatty liver disease (NAFLD) prognosis-related \"NAFLD outcomes score (NOS)\" effectively differentiated patients with disease progression. Standard laboratory data analyses revealed that high total bilirubin and low albumin levels were risk factors. A multivariate analysis with significant factors other than NOS score revealed that the absence of obesity and/or diabetes complications, a high FIB-4 index, and a high total bilirubin level were independent factors for liver-related events. Conclusion A high NOS score, absence of obesity and/or diabetes complications, a high FIB-4 index, and high total bilirubin levels are risk factors for disease progression. Patients with lean phenotypes or non-diabetic SLD should also be assessed using non-invasive markers to determine their risks and potential outcomes.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"2425-2432"},"PeriodicalIF":1.1000,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425572/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical Variables That Predict Liver-related Events in Steatotic Liver Disease Diagnosed by a Liver Biopsy.\",\"authors\":\"Shinnosuke Okubo, Akinobu Takaki, Ikumi Sato, Takuya Adachi, Yasuto Takeuchi, Masahiko Sue, Nozomi Miyake, Hideki Onishi, Satoshi Hirohata, Motoyuki Otsuka\",\"doi\":\"10.2169/internalmedicine.4770-24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Objective Identifying patients at high risk of steatotic liver disease (SLD) is crucial. The liver fibrosis stage is the most reliable marker of liver-related mortality. However, non-invasive risk stratification methods remain controversial. Therefore, we analyzed the risk of liver-related events in patients who underwent a liver biopsy for metabolic dysfunction-associated steatotic liver disease (MASLD) or cryptogenic SLD at our hospital. Methods We retrospectively reviewed the clinical course of the patients to identify the occurrence of liver-related events. Patients This study included 146 patients diagnosed with SLD through a liver biopsy. Results Liver-related events occurred in 20 patients and were more frequent in those with advanced fibrosis than in those without advanced fibrosis. However, patients with advanced steatosis exhibit reduced disease progression. Patients with obesity and/or diabetes complications had a lower stage of fibrosis and better prognosis than the others. The non-invasive fibrosis-4 (FIB-4) index and non-alcoholic fatty liver disease (NAFLD) prognosis-related \\\"NAFLD outcomes score (NOS)\\\" effectively differentiated patients with disease progression. Standard laboratory data analyses revealed that high total bilirubin and low albumin levels were risk factors. A multivariate analysis with significant factors other than NOS score revealed that the absence of obesity and/or diabetes complications, a high FIB-4 index, and a high total bilirubin level were independent factors for liver-related events. Conclusion A high NOS score, absence of obesity and/or diabetes complications, a high FIB-4 index, and high total bilirubin levels are risk factors for disease progression. Patients with lean phenotypes or non-diabetic SLD should also be assessed using non-invasive markers to determine their risks and potential outcomes.</p>\",\"PeriodicalId\":13719,\"journal\":{\"name\":\"Internal Medicine\",\"volume\":\" \",\"pages\":\"2425-2432\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-08-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425572/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Internal Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2169/internalmedicine.4770-24\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2169/internalmedicine.4770-24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/8 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

摘要

目的鉴别脂肪变性肝病(SLD)高危患者至关重要。肝纤维化阶段是肝脏相关死亡率最可靠的标志。然而,无创风险分层方法仍然存在争议。因此,我们分析了在我院因代谢功能障碍相关脂肪变性肝病(MASLD)或隐源性SLD接受肝脏活检的患者发生肝脏相关事件的风险。方法回顾性分析患者的临床过程,确定肝脏相关事件的发生情况。本研究包括146例通过肝活检诊断为SLD的患者。结果20例患者发生肝脏相关事件,晚期纤维化患者比无晚期纤维化患者更频繁。然而,晚期脂肪变性患者表现出较低的疾病进展。伴有肥胖和/或糖尿病并发症的患者纤维化分期较低,预后较好。非侵袭性纤维化-4 (FIB-4)指数和非酒精性脂肪性肝病(NAFLD)预后相关的“NAFLD结局评分(NOS)”可有效区分疾病进展的患者。标准实验室数据分析显示,高总胆红素和低白蛋白水平是危险因素。多因素分析显示,没有肥胖和/或糖尿病并发症,高FIB-4指数和高总胆红素水平是肝脏相关事件的独立因素。结论NOS评分高、无肥胖和/或糖尿病并发症、FIB-4指数高、总胆红素水平高是疾病进展的危险因素。瘦表型或非糖尿病性SLD患者也应使用无创标记物评估其风险和潜在结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical Variables That Predict Liver-related Events in Steatotic Liver Disease Diagnosed by a Liver Biopsy.

Clinical Variables That Predict Liver-related Events in Steatotic Liver Disease Diagnosed by a Liver Biopsy.

Clinical Variables That Predict Liver-related Events in Steatotic Liver Disease Diagnosed by a Liver Biopsy.

Objective Identifying patients at high risk of steatotic liver disease (SLD) is crucial. The liver fibrosis stage is the most reliable marker of liver-related mortality. However, non-invasive risk stratification methods remain controversial. Therefore, we analyzed the risk of liver-related events in patients who underwent a liver biopsy for metabolic dysfunction-associated steatotic liver disease (MASLD) or cryptogenic SLD at our hospital. Methods We retrospectively reviewed the clinical course of the patients to identify the occurrence of liver-related events. Patients This study included 146 patients diagnosed with SLD through a liver biopsy. Results Liver-related events occurred in 20 patients and were more frequent in those with advanced fibrosis than in those without advanced fibrosis. However, patients with advanced steatosis exhibit reduced disease progression. Patients with obesity and/or diabetes complications had a lower stage of fibrosis and better prognosis than the others. The non-invasive fibrosis-4 (FIB-4) index and non-alcoholic fatty liver disease (NAFLD) prognosis-related "NAFLD outcomes score (NOS)" effectively differentiated patients with disease progression. Standard laboratory data analyses revealed that high total bilirubin and low albumin levels were risk factors. A multivariate analysis with significant factors other than NOS score revealed that the absence of obesity and/or diabetes complications, a high FIB-4 index, and a high total bilirubin level were independent factors for liver-related events. Conclusion A high NOS score, absence of obesity and/or diabetes complications, a high FIB-4 index, and high total bilirubin levels are risk factors for disease progression. Patients with lean phenotypes or non-diabetic SLD should also be assessed using non-invasive markers to determine their risks and potential outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Internal Medicine
Internal Medicine 医学-医学:内科
CiteScore
1.90
自引率
8.30%
发文量
0
审稿时长
2.2 months
期刊介绍: Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信