Incidence of non-alcoholic fatty liver disease in Hong Kong: A population study with paired proton-magnetic resonance spectroscopy
Incidence of non-alcoholic fatty liver disease in Hong Kong: A population study with paired proton-magnetic resonance spectroscopy
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DOI：
10.1016/j.jhep.2014.08.041
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发表时间：
2015-01-01
影响因子：
25.7
通讯作者：
Chan, Henry Lik-Yuen
中科院分区：
文献类型：
--
作者：
Wong, Vincent Wai-Sun;Wong, Grace Lai-Hung;Chan, Henry Lik-Yuen
背景和目标：由于腹部超声检查不能可靠地量化肝脏脂肪变性，因此缺乏关于非酒精性脂肪性肝病（NAFLD）发病率的准确数据。我们的目的是研究非酒精性脂肪肝的人口发病率与国家的最先进的非侵入性tests.Methods：这是一个前瞻性队列研究。应用质子磁共振波谱技术对社区人群肝内甘油三酯（IHTG）含量进行了动态监测。瞬时弹性成像进行评估肝fibrosis.Results：565例受试者（平均年龄48岁，62.7%的妇女）没有NAFLD在基线进行了随访评估后，中位数间隔47个月（范围34-60个月）。78例（13.8%）受试者发生偶发脂肪肝，平均IHTG含量为8.9%（SD 5.3%）。16例（20.5%）受试者的IHTG含量P11.0%，提示中度至重度脂肪变性。在排除2名有大量饮酒的男性后，3-5年时NAFLD的人群发病率为13.5%（95% CI 10.6-16.3%;每年3.4%）。仅1例发生NAFLD的受试者具有提示晚期纤维化的高肝硬度（11.1 kPa）。基线时的代谢综合征是脂肪肝事件的最强预测因子。31.0%的脂肪肝患者和5.6%的非脂肪肝患者发生中心性肥胖（P < 0.001）。没有发生脂肪肝的受试者空腹血糖受损的消退，发生在51.1%的没有发生脂肪肝的受试者中（p = 0.001）。结论：13.5%的香港中国成年人在3-5年内发展为NAFLD，但很少有严重的脂肪变性或晚期纤维化。代谢综合征是非酒精性脂肪肝最重要的危险因素。(C)2014年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background & Aims: Because abdominal ultrasonography cannot reliably quantify hepatic steatosis, accurate data on the incidence of non-alcoholic fatty liver disease (NAFLD) are lacking. We aimed to study the population incidence of NAFLD with state-of- the-art non-invasive tests.Methods: This was a prospective cohort study. The intrahepatic triglyceride (IHTG) content was measured serially with protonmagnetic resonance spectroscopy in community subjects. Transient elastography was performed to assess liver fibrosis.Results: 565 subjects (mean age 48 years, 62.7% women) without NAFLD at baseline underwent follow-up assessment after a median interval of 47 months (range 34-60 months). 78 (13.8%) subjects developed incident fatty liver with a mean IHTG content of 8.9% (SD 5.3%). 16 (20.5%) subjects had an IHTG content P11.0% suggestive of moderate to severe steatosis. After excluding 2 men with significant alcohol consumption, the population incidence of NAFLD at 3-5 years was 13.5% (95% CI 10.6-16.3%; 3.4% per year). Only 1 subject with incident NAFLD had high liver stiffness 11.1 kPa) suggestive of advanced fibrosis. Metabolic syndrome at baseline was the strongest predictor of incident fatty liver. Incident central obesity developed in 31.0% of subjects with incident fatty liver and 5.6% of those without (p < 0.001). No subject with incident fatty liver had regression of impaired fasting glucose, which occurred in 51.1% of those without incident fatty liver (p = 0.001).Conclusions: 13.5% of the Hong Kong Chinese adult population develop NAFLD in 3-5 years, but few have severe steatosis or advanced fibrosis. Metabolic syndrome is the most important risk factor of incident NAFLD. (C) 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.