代谢性脂肪变性肝病高危人群中脂肪性肝炎和肝纤维化的非侵入性评估

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.102018

Laís Siqueira Maia , Juliana Rodrigues Caldas , Rodrigo Nogueira Alonso , Juliana de Albuquerque Magella Mussnich , Maria Paula Silva Bernardes , João Marcello Neto de Araújo , Luis Guillermo Coca Velarde , Maria Auxiliadora Nogueira Saad , Débora Vieira Soares , Priscila Pollo-Flores

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引用次数: 0

摘要

全球代谢功能障碍相关脂肪变性肝病（MASLD）的总体患病率为30%，拉丁美洲的患病率更高（44.4%）。代谢功能障碍相关脂肪性肝炎（MASH）是MASLD的一种，可发展为晚期纤维化、肝硬化、肝功能失代偿和肝细胞癌。非侵入性检查（NITs）可以帮助识别和监测MASH的进展，以及预测肝脏相关结局的风险。在MASLD高危人群中使用无创试验评估脂肪性肝炎、肝纤维化和进展预测因子之间的关系。材料和方法一项前瞻性观察性研究，基于对某三级医院提供知情同意的成年人的横断面数据的分析。纳入标准为年龄在18至75岁之间，存在2型糖尿病、肥胖或代谢综合征。采用FIB 4指数、超声脂肪肝指数（FLI）、瞬时弹性成像和横波弹性成像。使用R对数据进行分析，并提交非参数Mann-Whitney或Wilcoxon检验。采用显著水平5%。结果本研究纳入131例患者。其中，81人（61.8%）患有脂肪性肝炎（FLI≥4），35人（26.7%）患有显著纤维化（F≥2），17人（12.9%）患有晚期纤维化（F≥3）。γ -谷氨酰胺转移酶（GGT）是唯一与脂肪性肝炎（p = 0.01582）和显著纤维化（p = 0.0217）有统计学显著相关的血清生物标志物。数据如表1所示。结论GGT与脂肪性肝炎和显著纤维化存在显著相关，提示GGT可作为提醒临床医生注意MASH和纤维化存在的额外标志物。

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NON-INVASIVE ASSESSMENT OF STEATOHEPATITIS AND LIVER FIBROSIS IN THE POPULATION AT RISK FOR METABOLIC STEATOTIC LIVER DISEASE

Introduction and Objectives

The overall global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is 30%, with a higher prevalence in Latin America (44,4%). Metabolic dysfunction-associated steatohepatitis (MASH) is a spectrum of MASLD that can progress to advanced fibrosis, cirrhosis, hepatic decompensation and hepatocellular carcinoma. Non-invasive tests (NITs) can help identify and monitor the progression of MASH, as well as predict the risk of liver-related outcomes.

To evaluate the association between steatohepatitis, liver fibrosis and progression predictors using non-invasive tests in the population at risk for MASLD.

Materials and Methods

A prospective observational study based on the analysis of cross-sectional data from adults in a tertiary hospital who provided informed consent. Inclusion criteria were age between 18 and 75 years and the presence of type 2 diabetes, obesity or metabolic syndrome. The NITs used were FIB 4 index, ultrassonography Fatty Liver Index (FLI), transient elastography and shear wave elastography. Data were analyzed using R and were submitted to the non-parametric Mann-Whitney or Wilcoxon tests. A significant level of 5% was adopted.

Results

This study included 131 patients. Of these, 81 (61.8%) had steatohepatitis (FLI≥ 4), 35 (26.7%) significant fibrosis (F≥ 2) and 17 (12.9%) advanced fibrosis (F≥ 3). Gamma-glutamil transferase (GGT) was the only serum biomarker with a statistically significant correlation with both steatohepatitis (p = 0.01582) and significant fibrosis (p = 0.0217). Data are described in table1.

Conclusions

GGT was significantly associated with the presence of steatohepatitis and significant fibrosis, suggesting that GGT may serve as an additional marker to alert clinicians to the presence of MASH and fibrosis.

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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.