非酒精性脂肪肝(NAFLD)表型的转归研究

2016-11-14 MedSci MedSci原创

根据2016年肝病会议上提出的研究,非酒精性脂肪肝(NAFLD)活动度评分及体重变化,可以预测疾病进展。 自弗吉尼亚州立大学的Arun J. Sanyal博士和同事们对来自NASH CRN数据库的394名NAFLD成年患者进行了研究。这些成人患者既往接受活检,然后进行临床和实验室检查,直到下一次活检。对资料完整的197例患者(子集)进行了多因素logistic回归模型分析,以确定NAFLD进

根据2016年肝病会议上提出的研究,非酒精性脂肪肝(NAFLD)活动度评分及体重变化,可以预测疾病进展。

自弗吉尼亚州立大学的Arun J. Sanyal博士和同事们对来自NASH CRN数据库的394名NAFLD成年患者进行了研究。这些成人患者既往接受活检,然后进行临床和实验室检查,直到下一次活检。对资料完整的197例患者(子集)进行了多因素logistic回归模型分析,以确定NAFLD进展和回归的危险因素。

总体而言,肝活检结果显示,75例为无脂肪性肝炎的脂肪肝,74例有交界性脂肪性肝炎,245例有明确的脂肪性肝炎。关于NAFLD表型的改变,44%的无脂肪性肝炎脂肪肝进展到交界性或明确的脂肪性肝炎,13%的患者其脂肪肝得到解决。

Sanyal说:“交界性脂肪性肝炎患者更容易出现疾病进展,而不是回归(43% vs. 22%)。”

本队列中与进展为交界性或明确的脂肪性肝炎相关的因素是,第一次肝活检和第二次肝活检之间的以下变化:丙氨酸氨基转移酶水平升高(P = .03)、NAFLD活动度评分恶化(P = .007)、体重增加(P = .02)。

此外,43%的交界性脂肪性肝炎患者进展为明确的脂肪性肝炎,23%的回归到交界性脂肪性肝炎的脂肪肝,4%则回归到非NAFLD疾病。20%的明确脂肪性肝炎患者回归到交界性脂肪性肝炎,11%的患者回归到脂肪肝,11%的患者回归到非NAFLD疾病。

研究者观察了基线纤维化患者的纤维化程度变化。在基线时,25%的脂肪肝患者有一定程度的纤维化。中等数量的患者出现进展。脂肪肝、交界性脂肪性肝炎和明确的脂肪性肝炎患者,其纤维化恶化和回归的患者比例分别为:21%、30%、29%与53%、34%、36%。

研究人员还发现,基线NAFLD活动度评分与纤维化的进展和回归有关。

原始出处:


Kleiner DE, et al. Abstract 37. Presented at: The Liver Meeting; Nov. 11-15, 2016; Boston.

NAFLD phenotypes progress and regress over time.Healio.November 13, 2016

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    2017-02-04 lvygwyt2781
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    2016-11-27 李东泽

    很好,不错,以后会多学习

    0

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    2016-11-19 136****0753赵

    值得学习。

    0

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    2016-11-16 tastas

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邴铁军:一个非酒精性脂肪肝(NASH)药物的交易

上个星期的一个FierceBiotech的新闻让我思考了许多,近期一直没有时间整理,今晚感觉家里和工作中的事渐渐走入正轨,等不得了,一定要查一查,看个究竟。 那则消息还是出自John Carroll之手,在Gilead和Nimbus的主页也可以看到这项交易:主要是Gilead以$1.2Billion的价格购买了Nimbus的一个处于研发早期的项目(The Nimbus Apollo prog

J Hepatol:久坐增加患非酒精性脂肪肝风险

久坐的行为意味着你实际上已经处于“安眠”(静止)状态——你几乎不怎么动,因此能量消耗很少。 许多研究都已经表明,久坐的行为会导致肥胖、糖尿病、高血压、心脏和血管的疾病、癌症甚至死亡的发生。 2008年美国运动指南建议,成年人每周应进行2.5小时中至高强度体育运动。然而,全国健康和营养调查协会(NHANES)指出,一天当中,人们平均有55%的时间处于静坐状态。 这项研究发表在Hepatology,主

JAMA Intern Med:非酒精性脂肪肝患者中等强度的运动即可

近期发表在JAMA Internal Medicine的研究称,对于非酒精性脂肪性肝病(NAFLD)患者,适度和剧烈运动对于肝脏脂肪的减少没有显著差异。文中的剧烈运动为最大心率的65%-80%的运动,而适度则是最大心率的45%-55%的运动。杜兰大学公共卫生与热带医学学院流行病学系的博士后研究员Hui-Jie Zhang博士和他的同事进行了一项随机临床试验,纳入220例中央肥胖和非酒精性脂肪性肝病

盘点:近期非酒精性脂肪肝治疗新近进展

脂肪肝,是指由于各种原因引起的肝细胞内脂肪堆积过多的病变。脂肪性肝病正严重威胁国人的健康,成为仅次于病毒性肝炎的第二大肝病。脂肪肝是一种常见的临床现象,而非一种独立的疾病。其临床表现轻者无症状,重者病情凶猛。非酒精性脂肪性肝病(NAFLD)是指除外酒精和其他明确的损肝因素所致的肝细胞内脂肪过度沉积为主要特征的临床病理综合征,与胰岛素抵抗和遗传易感性密切相关的获得性代谢应激性肝损伤。非酒精性脂肪