Autoimmune hepatitis and metabolic syndrome-associated disease development: a U.S. cohort study.
Autoimmune hepatitis and metabolic syndrome-associated disease development: a U.S. cohort study.
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自身免疫性肝炎和代谢综合征相关疾病的发展：美国队列研究。
DOI：
10.1111/apt.17191
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发表时间：
2022
影响因子：
7.6
通讯作者：
Bittermann,Therese
中科院分区：
文献类型：
--
作者：
Jalal,MuhammadI;Brahmbhatt,Mihir;Green,Kelsey;Weinberg,EthanM;Lammert,Craig;Bittermann,Therese
背景自身免疫性肝炎（AIH）可能与代谢综合征相关疾病（MSAD）共存，因为患者对皮质类固醇治疗的内在需求以及总体人群趋势.AimTo检查MSAD风险因素对AIH或其治疗的影响，以及副作用方法这是一项多中心回顾性队列研究，包括2000年1月至2019年12月诊断的552例AIH患者。在诊断时以及1年和3年随访时收集与人口统计学因素、实验室检查值、AIH药物和MSAD相关的数据。统计关系进行了分析和reported.ResultsWe包括552例患者在研究队列（中位年龄50岁，76.1%的女性）。所有MSAD，包括高血压、血脂异常、糖尿病和BMI增加≥3 kg/m2，在AIH队列中均随时间增加。初始治疗方案影响新发糖尿病，但不影响其他MSAD的发展。诊断后3年，MSAD ≥1的患者中AIH生化缓解的频率较低。在某些cases.ConclusionIn最大的美国为基础的新诊断为AIH的患者队列中，新的MSAD的发病率可以通过基线因素进行预测，有相当大的负担，既存和de novoMSAD可能会影响AIH的治疗结果。识别那些合并MSAD风险最高的患者，可以采用个性化的管理方法，以减少AIH患者的长期后遗症。
BackgroundAutoimmune hepatitis (AIH) may coexist with metabolic syndrome‐associated diseases (MSADs) given patients' inherent need for corticosteroid therapy, as well as general population trends.AimTo examine the impact of MSAD risk factors on AIH or its treatment, andvice versaMethodsThis was a multi‐centre retrospective cohort study of 552 patients with AIH diagnosed between January 2000 and December 2019. Data relating to demographic factors, laboratory values, AIH medications and MSADs were collected at diagnosis and at 1‐ and 3‐year follow‐up. Statistical relationships were analysed and reported.ResultsWe included 552 patients in the study cohort (median age 50 years, 76.1% female). All MSADs, including hypertension, dyslipidaemia, diabetes and a gain of BMI ≥3 kg/m2, increased within the AIH cohort over time. Initial treatment regimen impactedde novodiabetes but not other MSAD development. AIH biochemical remission was less frequent at 3 years post‐diagnosis among patients with ≥1 MSAD. The incidence of new MSADs could be predicted by baseline factors in certain cases.ConclusionIn the largest US‐based cohort of patients newly diagnosed with AIH, there was a considerable burden of pre‐existing andde novoMSADs that may affect AIH treatment outcomes. Identifying those at highest risk of co‐morbid MSADs allows for an individualised approach to management to reduce its long‐term sequelae in patients with AIH.