Components of metabolic syndrome increase the risk of mortality in nonalcoholic fatty liver disease (NAFLD).
Components of metabolic syndrome increase the risk of mortality in nonalcoholic fatty liver disease (NAFLD).
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DOI：
10.1097/md.0000000000010214
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发表时间：
2018-03
期刊：
影响因子：
1.6
通讯作者：
Younossi ZM
中科院分区：
文献类型：
--
作者：
Golabi P;Otgonsuren M;de Avila L;Sayiner M;Rafiq N;Younossi ZM
非酒精性脂肪性肝病(NAFLD)是美国慢性肝病最常见的原因。代谢综合征(MS)成分在NAFLD中非常普遍。我们的目的是评估非酒精性脂肪肝和多发性硬化症与长期死亡率的关系。采用第三次国民健康与营养调查(NHANES)。非酒精性脂肪肝是在有肝脏脂肪变性和没有其他慢性肝病原因的情况下通过超声诊断出来的。多发性硬化症及其组成部分的病史由自报的NHANES问卷获得。死亡率是从死亡-联系档案中获得的，截至2011年12月31日。分类变量采用卡方检验，COX比例模型以95%的可信区间估计危险比。非酒精性脂肪肝队列(n = 3613)的中位年龄为43岁，73%为白人，50%为男性。与有至少一种MS症状的NAFLD组相比，有至少一种MS症状的NAFLD组年龄明显增大，体重指数更高，更有可能出现胰岛素抵抗，并患有心脏病。经过19年以上的随访，1039人死亡。与无代谢综合征的非酒精性脂肪肝患者相比，有一种代谢综合征成分的患者8年(2.6%比4.7%)和16年(6%比11.9%)的死亡风险增加(P <； .001)。在调整了社会人口因素后，所有MS成分的NAFLD与总死亡率、心脏死亡率和肝脏死亡率相关。MS组分数量增加与生存率降低相关(P <； .0001)。与无MS的NAFLD患者相比，NAFLD和MS患者的死亡风险更高，应优先考虑这些NAFLD患者的治疗方案。
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the United States. Metabolic syndrome (MS) components are highly prevalent in NAFLD. Our aim is to assess the relationship of NAFLD and MS with long-term outcome of mortality. The Third National Health and Nutrition Examination Survey (NHANES) was utilized. NAFLD was diagnosed by ultrasound in the presence of hepatic steatosis and no other causes of chronic liver disease. History of MS and its components were obtained from self-reported NHANES questionnaires. Mortality was obtained from Mortality-Linkage File, through December 31, 2011. Chi-square test was used for categorical variables and Cox proportional models estimated hazard ratios with 95% confidence interval. NAFLD cohort (n = 3613) had a median age of 43 years, 73% white, and 50% male. NAFLD group with at least one MS condition was significantly older, had higher body mass index, more likely to have insulin resistance, and heart disease compared to NAFLD group without MS. Over 19-years of follow-up, 1039 people died. Compared to NAFLD patients without MS, presence of one MS component increased the risk of mortality at 8-year (2.6% vs 4.7%) and 16-year (6% vs 11.9%) (P < .001). After adjusting for socio-demographic factors, NAFLD with all MS components was associated with overall, cardiac and liver-mortality. Increased number of MS components was associated with lower survival (P < .0001). Patients with NAFLD and MS have higher mortality risk compared to NAFLD patients without MS. These NAFLD patients should be prioritized for the development of treatment regimens.