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BMC Gastroenterology: 肥胖与高尿酸血症相互作用对非酒精性脂肪肝疾病的严重性影响

2021-02-06 MedSci原创 MedSci原创

非酒精性脂肪性肝病(NAFLD)是发展最快的慢性肝病,流行病学数据表明,目前全球NAFLD的患病率为25%。

非酒精性脂肪性肝病(NAFLD)是发展最快的慢性肝病,流行病学数据表明,目前全球NAFLD的患病率为25%,如今,中国正处于NAFLD的快速发展时期,全国患病率高达29.2%。众所周知,NAFLD会增加肝硬化和肝细胞癌的风险。在美国,每年的直接医疗费用约为1030亿美元(每位患者1613美元),在欧洲,每年的直接医疗费用为350亿欧元(每位患者从354欧元到1163欧元)。NAFLD与代谢综合征及其相关病症密切相关,包括肥胖,2型糖尿病,血脂异常,高血压和高尿酸血症。先前的研究表明,高尿酸血症与NAFLD肝损害的严重程度之间存在独立的联系。因此,这项研究的目的是探究肥胖状况是否可以改变血清尿酸与NAFLD肝损害严重程度之间的关系,以及高尿酸血症和肥胖可能的相互作用。

 

 

       研究人员对总共557例经超声诊断的NAFLD进行了横断面研究。通过瞬时弹性成像定量评估肝脂肪变性和肝纤维化程度。高尿酸血症定义为男性的血清尿酸> 420μmol/ L,女性> 360μmol/ L,肥胖的定义为体重指数≥25 kg/m2。通过多元logistic回归分析分析调整后的高尿酸血症和肥胖症的OR值,并使用加性模型研究可能的交互作用。

 

 

      多元回归分析表明,高尿酸血症与严重的肝脂肪变性(1.74 [1.09–2.79])和ALT升高(2.17 [1.38–3.41])有关,而与晚期纤维化无关(1.61 [0.91–2.85])。同时,研究人员发现仅在肥胖的NAFLD中,高尿酸血症与发生严重肝脂肪变性的几率较高(2.02 [1.14–3.57])和ALT升高(2.27 [1.37–3.76])相关,而非肥胖受试者则没有这样的现象。同样,高尿酸血症患者在肥胖者中发生纤维化的几率更高(2.17 [1.13-4.18]),而非肥胖者(0.60 [0.14-2.70])则没有。此外,在严重肝脂肪变性(AP:0.39 [0.01–0.77])和晚期纤维化的可能性上,高尿酸血症和肥胖之间存在互相加持的相互作用。

 

本项研究证实高尿酸血症和肥胖症对肝脂肪变性和纤维化具有明显的协同作用。因此,在肥胖的NAFLD中可能需要针对尿酸的治疗。

原始出处:

Mimi Zhou. Et al. Obesity interacts with hyperuricemia on the severity of non-alcoholic fatty liver disease. BMC Gastroenterology.2021.

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    2021-04-17 许安
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  5. 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  6. 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  7. 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GetPortalCommentsPageByObjectIdResponse(id=1975052, encodeId=4a3819e505240, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Thu Mar 25 18:06:53 CST 2021, time=2021-03-25, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1673645, encodeId=18ab16e3645ac, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Wed Jan 19 20:06:53 CST 2022, time=2022-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073241, encodeId=3ee120e32416a, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, 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href='/topic/show?id=6dd7211832f' target=_blank style='color:#2F92EE;'>#严重性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21183, encryptionId=6dd7211832f, topicName=严重性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Apr 20 14:06:53 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=945017, encodeId=28a194501e10, content=goodnews, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210127/50a003c4097845e182c08afd64d8a509/bd766dfebe9c40e0bca2dae964601bdc.jpg, createdBy=22de5454917, createdName=carrotlyl, createdTime=Wed Mar 03 06:44:52 CST 2021, time=2021-03-03, status=1, ipAttribution=), 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    2021-04-20 xue8602
  9. 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    2021-03-03 carrotlyl

    goodnews

    0

  10. 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用bimagrumab阻断激活素受体可以为管理伴有过度肥胖的2型糖尿病患者提供一种新的药物治疗方法。

J Immunother Cancer:肥胖会减弱肾癌患者采用抗PD-1免疫治疗的疗效

肥胖是肾癌的一个主要危险因素,但我们对其对抗肿瘤免疫和免疫治疗结果的影响仍不完全了解。考虑到越来越多的免疫检查点抑制剂将用于治疗转移性疾病,以及越来越多的证据表明,在癌症免疫疗法的背景下存在肥胖悖论

ATVB:年龄、更年期和肥胖对与血管健康相关氧化脂质的影响

绝经前女性中较高的12-脂氧合酶 oxylipin血浆浓度与较低的动脉僵硬度可能是重要的贡献心血管疾病中性别差异的因素。

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