Metabolic dysfunction‐associated fatty liver disease directly related to liver fibrosis independent of insulin resistance, hyperlipidemia, and alcohol intake in morbidly obese patients
Metabolic dysfunction‐associated fatty liver disease directly related to liver fibrosis independent of insulin resistance, hyperlipidemia, and alcohol intake in morbidly obese patients
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代谢功能障碍相关的脂肪肝与病态肥胖患者的肝纤维化直接相关，与胰岛素抵抗、高脂血症和酒精摄入无关
DOI：
10.1111/hepr.13808
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发表时间：
2022
影响因子：
4.2
通讯作者：
Oshiro Kouichi
中科院分区：
文献类型：
--
作者：
Inamine Susumu;Kage Masayoshi;Akiba Jun;Kawaguchi Takumi;Yoshio Sachiyo;Kawaguchi Machiko;Nakano Dan;Tsutsumi Tsubasa;Hashida Ryuki;Oshiro Kouichi
肝纤维化与多种因素相关，包括代谢功能障碍相关性脂肪肝（MAFLD），胰岛素抵抗和病态肥胖患者的酒精摄入。我们调查了与病态肥胖患者肝纤维化直接相关的因素，使用图形model.MethodsWe招募了134例连续病态肥胖患者，他们在袖状胃切除术期间接受了肝活检（中位年龄43.5岁; MAFLD 78.4%;胰岛素抵抗[HOMA-IR] 5.97; >20 g/天酒精摄入量14.2%）。根据组织学将患者分为无/轻度（F0/1;n= 77）或显著/晚期纤维化（F2/3;n= 57）组。结果F2/3的发生率为42.5%。F2/3组的MAFLD和HOMA-IR值的患病率显著高于F0/1组;但是，两组之间未观察到酒精摄入量的显著差异。在逻辑回归分析中，MAFLD，而不是HOMA-IR或酒精摄入，是与F2/3相关的唯一独立因素（比值比7.555; 95%置信区间2.235-25.544;p= 0.0011）。图形模型显示F2/3与MAFLD、糖尿病、HOMA-IR和低密度脂蛋白胆固醇直接相互作用。在这些因素中，MAFLD与F2/3的交互作用最强。结论MAFLD与严重/晚期肝纤维化的关系比胰岛素抵抗和高脂血症更直接，饮酒与肝纤维化无直接关系。代谢功能障碍相关的脂肪肝可能是病态肥胖患者肝纤维化的最重要因素。
AimHepatic fibrosis is associated with various factors, including metabolic dysfunction‐associated fatty liver disease (MAFLD), insulin resistance, and alcohol intake in patients with morbid obesity. We investigated factors directly associated with hepatic fibrosis in patients with morbid obesity using a graphical model.MethodsWe enrolled 134 consecutive patients with morbid obesity who underwent liver biopsy during sleeve gastrectomy (median age 43.5 years; MAFLD 78.4%; homeostasis model assessment of insulin resistance [HOMA‐IR] 5.97; >20 g/day alcohol intake 14.2%). Patients were classified into none/mild (F0/1;n= 77) or significant/advanced fibrosis (F2/3;n= 57) groups, based on histology. Factors associated with F2/3 were analyzed using logistic regression analysis and a graphical model.ResultsF2/3 was observed in 42.5% of the enrolled patients. The prevalence of MAFLD and HOMA‐IR values were significantly higher in the F2/3 group than in the F0/1 group; however, no significant difference in alcohol intake was observed between the two groups. On logistic regression analysis, MAFLD, but not HOMA‐IR or alcohol intake, was the only independent factor associated with F2/3 (odds ratio 7.555; 95% confidence interval 2.235–25.544;p= 0.0011). The graphical model revealed that F2/3 directly interacted with MAFLD, diabetes mellitus, HOMA‐IR, and low‐density lipoprotein cholesterol. Among these factors, MAFLD showed the strongest interaction with F2/3.ConclusionsWe determined that MAFLD was more directly associated with significant/advanced fibrosis than insulin resistance or hyperlipidemia, and alcohol intake was not directly associated with hepatic fibrosis. Metabolic dysfunction‐associated fatty liver disease could be the most important factor for hepatic fibrosis in patients with morbid obesity.
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代谢功能障碍相关的脂肪肝
影响因子：
1.9
作者：
Zongmei Wu
通讯作者：
Zongmei Wu
影响因子：
8.9
作者：
Kawaguchi, Takumi;Tsutsumi, Tsubasa;Nakano, Dan;Eslam, Mohammed;George, Jacob;Torimura, Takuji
通讯作者：
Torimura, Takuji
影响因子：
6.3
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通讯作者：
Koike K
影响因子：
5.1
作者：
Ho, Cheng-Maw;Ho, Shu-Li;Lee, Po-Huang
通讯作者：
Lee, Po-Huang
影响因子：
2.2
作者：
Araki, Eiichi;Goto, Atsushi;Yoshioka, Narihito
通讯作者：
Yoshioka, Narihito