Characterization of lean patients with nonalcoholic fatty liver disease: potential role of high hemoglobin levels
Characterization of lean patients with nonalcoholic fatty liver disease: potential role of high hemoglobin levels
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DOI：
10.3109/00365521.2014.983160
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发表时间：
2015-03-01
影响因子：
1.9
通讯作者：
Yilmaz, Yusuf
中科院分区：
文献类型：
--
作者：
Akyuz, Umit;Yesil, Atakan;Yilmaz, Yusuf
客观的。超重和肥胖是发生非酒精性脂肪肝（NAFLD）的主要危险因素。然而，少数 NAFLD 患者的体重指数 (BMI) < 25 kg/m(2)（瘦 NAFLD）。我们试图调查瘦 NAFLD 和与超重/肥胖相关的更常见形式的 NAFLD 之间是否存在显着差异。患者和方法。共有 483 名连续活检证实患有 NAFLD 的患者入组。瘦 NAFLD 的定义是 BMI < 25 kg/m(2)。我们确定了 37 名轻度 NAFLD 患者 (7.6%)。结果。与超重/肥胖的 NAFLD 患者相比，瘦 NAFLD 患者更年轻、血压值更低、血红蛋白水平更高、代谢综合征患病率更低、肝纤维化程度更轻。在超重/肥胖的 NAFLD 患者中，糖尿病是非酒精性脂肪性肝炎 (NASH) 的唯一独立预测因素。在瘦型 NAFLD 中，与 NASH 独立相关的唯一变量是血红蛋白。丙氨酸氨基转移酶和糖尿病是超重/肥胖 NAFLD 患者纤维化≥2 的独立预测因子，而血红蛋白是瘦 NAFLD 纤维化≥2 的唯一独立预测因子。结论。总之，瘦 NAFLD 患者更年轻，肝纤维化程度也较轻。然而，这些受试者的血红蛋白水平较高，这似乎可以预测组织学的严重程度。
Objective. Overweight and obesity are major risk factors for the development of nonalcoholic fatty liver disease (NAFLD). However, a minority of NAFLD patients have a body mass index (BMI) < 25 kg/m(2) (lean NAFLD). We sought to investigate whether significant differences exist between lean NAFLD and more common forms of NAFLD associated with overweight/obesity. Patients and methods. A total of 483 consecutive patients with biopsy-proven NAFLD were enrolled. Lean NAFLD was defined as having a BMI < 25 kg/m(2). We identified 37 patients with lean NAFLD (7.6%). Results. Compared with NAFLD patients with overweight/obesity, lean NAFLD patients were younger, had lower blood pressure values, higher levels of hemoglobin, a lower prevalence of the metabolic syndrome, and less severe hepatic fibrosis. In NAFLD patients with overweight/obesity, diabetes was the only independent predictor of nonalcoholic steatohepatitis (NASH). In lean NAFLD, the only variable independently associated with NASH was hemoglobin. Alanine aminotransferase and diabetes were independent predictors of fibrosis >= 2 in NAFLD patients with overweight/obesity, whereas hemoglobin was the only independent predictor of fibrosis >= 2 in lean NAFLD. Conclusion. In summary, lean NAFLD patients are younger and show less severe hepatic fibrosis. However, such subjects have higher hemoglobin levels, which seem to predict the histological severity.