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Obesity:非酒精性脂肪肝病严重威胁代谢健康

2019-07-20 国际糖尿病编辑部 国际糖尿病

非酒精性脂肪肝病(NAFLD)目前已经成为一项全球流行性疾病,预计影响全球约25%~44%的人口。近期发表的一项基于韩国人群的队列研究显示NAFLD患者与那些有健康肝脏的人相比,更容易出现代谢不健康状态。该研究发表在近期的obesity上。

编者按:非酒精性脂肪肝病(NAFLD)目前已经成为一项全球流行性疾病,预计影响全球约25%~44%的人口。近期发表的一项基于韩国人群的队列研究显示NAFLD患者与那些有健康肝脏的人相比,更容易出现代谢不健康状态。该研究发表在近期的obesity上。

韩国成均馆大学医学院内分泌与代谢系Park教授研究团队对一项韩国人群长期队列研究(Kangbuk Samsung Health Study)中的22 551例成人(平均年龄41.9岁,女性占39.7%)进行了约5.1年随访。研究人员测量了血糖和胰岛素水平、血压、体重、身高、胆固醇和腰围,并通过腹部超声确定是否存在脂肪肝。受试者在基线访视后每年都会返回研究中心进行医学评估。受试者在随访期间达到两个及以上不健康代谢状态的阈值[包括肥胖、甘油三酯>150 mg/dl、高密度脂蛋白胆固醇<40 mg/dl(男性)或50 mg/dl(女性),血压至少为130 mmHg/85 mmHg或葡萄糖水平>100mg/dl],将被认为已转变为代谢不健康状态。

研究结果显示,23.8%的受试者患有NAFLD,与无NAFLD受试者相比,有NAFLD的受试者代谢不健康的风险较高(OR=1.53,95%CI:1.49~1.56)。调整年龄、性别、体重指数、生活方式因素、血压、甘油三酯、高密度脂蛋白胆固醇和葡萄糖水平后,NAFLD患者从代谢健康到代谢不健康的可能性增加(OR=1.29,95%CI:1.19~1.39)。

研究者指出在体重指数和脂肪含量最低的人群中,NAFLD对其代谢健康状态向不健康代谢状态的变化影响更显著,这种影响随人群体重指数和体脂含量增加而降低。(图1)



图1:NAFLD人群从代谢健康状态到代谢不健康状态在不同体重指数及脂肪含量中的的变化趋势

Park教授评述道:“目前这种差异的原因尚不清楚;然而,一种可能的解释是,与体重正常人群相比,肥胖者通常具有多种心血管危险因素,包括高甘油三酯和低HDL胆固醇水平、高血压、高血糖和胰岛素抵抗。与体重正常的人群相比,肥胖人群中这些代谢危险因素可能部分削弱了NAFLD作为代谢转化为不健康表型的预测因子的作用。”

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  5. 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Jul 22 14:53:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588376, encodeId=6f0115883e6a9, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Mon Jul 22 14:53:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370026, encodeId=88183e00264e, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 21 05:36:39 CST 2019, time=2019-07-21, status=1, ipAttribution=)]
    2019-12-24 zhanglin3079
  6. 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    2019-07-22 lingaifan
  7. 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  8. 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    2019-07-22 skhzy
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    2019-07-21 深海的鱼

    学习学习学习

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