Histological Course of Nonalcoholic Fatty Liver Disease in Japanese Patients - Tight glycemic control, rather than weight reduction, ameliorates liver fibrosis
Histological Course of Nonalcoholic Fatty Liver Disease in Japanese Patients - Tight glycemic control, rather than weight reduction, ameliorates liver fibrosis
复制标题
DOI：
10.2337/dc09-0148
复制
发表时间：
2010-02-01
期刊：
影响因子：
16.2
通讯作者：
Kaneko, Shuichi
中科院分区：
文献类型：
--
作者：
Hamaguchi, Erika;Takamura, Toshinari;Kaneko, Shuichi
目的：本研究的目的是研究日本非酒精性脂肪性肝病（NAFLD）患者在接受了一系列肝活检后所观察到的组织学变化是否与代谢异常有关。研究设计和方法：总共有39例患者接受了连续的肝活检。分析其临床资料的变化，并对活检标本进行组织学分期评分。结果：中位随访时间为2.4年（范围1.0-8.5）。12例患者肝纤维化改善（30.7%），11例患者进展（28.2%），16例患者保持不变（41%）。在Cox比例风险模型中，A1C的降低和胰岛素的使用与肝纤维化的改善相关，与年龄、性别和BMI无关。然而，在相互调整后，δ A1C与肝纤维化改善的相关性比使用胰岛素更强(chi(2)；分别为7.97和4.58)。结论：严格的血糖控制可以防止日本NAFLD患者的组织学进展。
OBJECTIVE - The goal of this study was to examine whether metabolic abnormalities are responsible for the histological changes observed in Japanese patients with nonalcoholic fatty liver disease (NAFLD) who have undergone serial liver biopsies.RESEARCH DESIGN AND METHODS - in total, 39 patients had undergone consecutive liver biopsies. Changes in their clinical data were analyzed, and biopsy specimens were scored histologically for stage.RESULTS - The median follow-up time was 2.4 years (range 1.0-8.5). Liver fibrosis had improved in 12 patients (30.7%), progressed in 11 patients (28.2%), and remained unchanged in 16 patients (41%). In a Cox proportional hazard model, decrease in A1C and use of insulin were associated with improvement of liver fibrosis independent of age, sex, and BMI. However, Delta A1C was more strongly associated with the improvement of liver fibrosis than use of insulin after adjustment for each other (chi(2); 7.97 vs. 4.58, respectively).CONCLUSIONS - Tight glycemic control may prevent histological progression in Japanese patients with NAFLD.