代谢功能障碍相关脂肪性肝病患者饮酒对肝脏和动脉粥样硬化的风险

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Atherosclerosis Pub Date : 2025-03-07 DOI:10.1016/j.atherosclerosis.2025.119161

Shao-Wen Wang , Ching Wang , Yu-Ming Cheng , Tsung-Han Hsieh , Chia-Chi Wang , Jia-Horng Kao

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引用次数: 0

摘要

背景/目的2023年提出了一个新的疾病名称“脂肪肝病（Steatotic Liver disease， SLD）”。在该算法中，代谢性和酒精性肝病（MetALD）被命名为一个新的特定亚群。MetALD患者的临床概况和预后尚不清楚。方法从台湾生物银行数据库中剔除HBsAg阳性、抗- hcv阳性和前饮酒者。如果超声检查伴有肝脂肪变性，再加上至少一项心脏代谢标准，则诊断为MASLD。增加或适度饮酒被定义为连续饮酒者，男性每周饮酒量超过210克，女性每周饮酒量超过140克或低于210克。采用纤维化4 （FIB-4）评分评估肝纤维化严重程度，采用双工超声检查颈动脉斑块诊断动脉粥样硬化。结果共18160例(平均年龄55.28±10.41；其中，MASLD患者7316例（40.3%），MetALD患者209例（1.2%）。MetALD患者以年轻男性为主。根据年龄和性别进行倾向评分匹配后，MetALD患者AST、GGT、脂肪肝指数（FLI）和FIB-4评分均高于MASLD患者，且颈动脉斑块比例往往高于MASLD患者。在MASLD患者中，适度饮酒的患者GGT、FLI和FIB-4评分较高，颈动脉斑块比例高于无饮酒或社交饮酒的患者。结论metald患者发生肝损伤的风险高于MASLD患者。此外，适度饮酒也会增加MASLD患者肝损伤和动脉粥样硬化的风险，提示MASLD患者应避免饮酒。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Liver and atherosclerotic risk of alcohol consumption in patients with metabolic dysfunction-associated Steatotic Liver Disease

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Liver and atherosclerotic risk of alcohol consumption in patients with metabolic dysfunction-associated Steatotic Liver Disease

Background/purpose

A new disease name, "Steatotic Liver Disease (SLD)" was proposed in 2023. Within this algorithm, combined metabolic and alcoholic liver disease (MetALD) was named as a new specific subgroup. The clinical profiles and outcomes of MetALD patients are unknown.

Methods

Participants from Taiwan Biobank database after exclusion those with positive for HBsAg, anti-HCV, and former drinkers were selected. MASLD was diagnosed if having hepatic steatosis on ultrasound plus at least one of cardiometabolic criteria. Increased or moderate alcohol intake was defined as continuous drinkers with alcohol consumption exceeding 210 g for men and 140 g for women weekly or below the levels, respectively. The fibrosis 4 (FIB-4) score was used to assess the severity of liver fibrosis, and carotid plaques on duplex ultrasound were employed to diagnose atherosclerosis.

Results

In a total of 18,160 (mean age 55.28 ± 10.41; 33.2 % males) participants, there were 7316 (40.3 %) MASLD patients and 209 (1.2 %) MetALD patients. The participants with MetALD were younger and male predominant. After propensity score matching for age and gender, MetALD patients had higher AST, GGT, fatty liver index (FLI), and FIB-4 score and tended to have a higher proportion of carotid plaques than MASLD patients. Among MASLD patients, those with moderate alcohol intake had higher values of GGT, FLI, and FIB-4 score and a higher proportion of carotid plaques than those with no or social alcohol intake.

Conclusions

MetALD patients have a higher risk of liver injury than those with MASLD. Moreover, moderatet alcohol intake also increases the risk of liver injury and atherosclerotic in MASLD patients, suggesting MASLD patients should refrain from alcohol intake.

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.