心脏代谢危险因素和酒精摄入对masld患者肝脏僵硬的影响：哥伦比亚的一项多中心研究

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.101979

Ismael de Jesus Yepes Barreto , Nicole Chamorro , Guillermo Donado , Pablo Osorio , Juan Carlos Restrepo , Santiago Pino , Clara Caez , Jorge Ortiz , Yohana Poveda

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引用次数: 0

摘要

代谢功能障碍相关脂肪变性肝病（MASLD）包括肝脂肪变性和至少一种心脏代谢危险因素（CMRF）的患者。然而，个体CMRFs及其相互作用对疾病进展的影响尚不清楚。为了评估CMRFs、它们的相互作用（包括酒精摄入）和MASLD患者肝僵硬之间的关系和方法，这项多中心研究纳入了来自哥伦比亚四个城市的MASLD患者。瞬时弹性成像用于评估肝脏硬度。排除了慢性肝病的其他原因。排除了显著酒精摄入量（男性≥30 g/天，女性≥20 g/天）的患者。CMRFs采用ATP III标准定义。根据标准饮酒单位，酒精消费量估计为每周克。一个多变量线性回归模型评估了肝僵硬的相关性，包括CMRFs和酒精之间的相互作用项。结果共纳入354例患者，平均年龄54岁，男性占39.3%。CMRF分布:1(30.2%)、2(31.9%),3(29.4%)和4(8.5%)。最常见的cmrf是血脂异常（68.6%）和高血压（54.2%）。在多变量分析中，BMI （β = 0.14;95% CI: 0.03 - 0.27; p = 0.012）和糖代谢受损（β = 0.11;95% CI: 0.08-2.6; p = 0.03）与肝脏僵硬独立相关。在相互作用项中，只有糖尿病与腰围的相互作用仍然显著（β = 0.19;95% CI: 1.15-4.4; p < 0.01）。酒精摄入则无关联。结论糖尿病及其与腰围的相互作用是MASLD患者肝脏僵硬的关键驱动因素，与酒精摄入无关。

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INFLUENCE OF CARDIOMETABOLIC RISK FACTORS AND ALCOHOL CONSUMPTION ON LIVER STIFFNESS IN PATIENTS WITH MASLD: A MULTICENTER STUDY IN COLOMBIA

Introduction and Objectives

Metabolic dysfunction-associated steatotic liver disease (MASLD) includes patients with hepatic steatosis and at least one cardiometabolic risk factor (CMRF). However, the influence of individual CMRFs and their interactions on disease progression remains unclear.

To assess the association between CMRFs, their interactions (including with alcohol consumption), and liver stiffness in MASLD

Patients and Methods

This multicenter study included patients with MASLD from four Colombian cities. Transient elastography was used to assess liver stiffness. Other causes of chronic liver disease were excluded. Patients with significant alcohol intake (≥30 g/day for men, ≥20 g/day for women) were excluded. CMRFs were defined using ATP III criteria. Alcohol consumption was estimated as grams per week based on standard drink units. A multivariate linear regression model evaluated associations with liver stiffness, including interaction terms between CMRFs and with alcohol. Statistical significance was set at p ≤ 0.05

Results

A total of 354 patients were included (mean age: 54 years; 39.3% male). CMRF distribution: 1 (30.2%), 2 (31.9%), 3 (29.4%), and 4 (8.5%). The most prevalent CMRFs were dyslipidemia (68.6%) and hypertension (54.2%). In multivariate analysis, BMI (β = 0.14; 95% CI: 0.03–0.27; p = 0.012) and impaired glucose metabolism (β = 0.11; 95% CI: 0.08–2.6; p = 0.03) were independently associated with liver stiffness. Among interaction terms, only the diabetes–waist circumference interaction remained significant (β = 0.19; 95% CI: 1.15–4.4; p < 0.01). Alcohol consumption showed no association.

Conclusions

Diabetes and its interaction with waist circumference are key drivers of liver stiffness in MASLD, independent of alcohol intake.

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.